Manoli/Chilvers/Biels F&A

External fixation is a useful tool for treating severe traumatic injuries to the foot and ankle. External fixation, however, does have associated complications, such as inadequate fixation and pin tract infections. Temporary bridge plating of the medial, lateral, or both columns is a useful alternative to external fixation for treating multilevel foot injuries. This article describes the technique of temporary bridge plating which may be used as an alternative to external fixation.

The purpose of this study was to develop a salvage procedure for failed fixation of ankle fractures that occurs in patients with sensory neuropathy. Six patients, with insensitivity to a 5.07 monofilament on the plantar surface of their foot (five with diabetes mellitus, one with alcoholic peripheral neuropathy) presented to a foot and ankle referral center with failed traditional fixation of their Weber B and C ankle fractures. Five fractures were the result of trauma. One fracture occurred without a discernable traumatic event...

Compartment syndrome should be treated early and aggressively to prevent late complications. Patients may have late deformity because of a failure of diagnosis, inadequate decompression, or a delay in fasciotomies. Late reconstruction will allow a plantigrade and relatively functional foot. Complete excision of scarred muscle will prevent recurrence in established deformities. Early treatment may prevent significant functional impairment by well-placed tenotomies. In patients with severe long-term deformities with extensive soft tissue contraction, incremental correction may be an appropriate intermediate intervention...

No abstract text is available yet for this article.

End-stage degenerative joint disease of the ankle and concomitant ipsilateral Stage II posterior tibial tendon insufficient flat foot is a well known entity. Despite this, treatment options have not been discussed in the orthopaedic literature. A case series consisting of five patients was conducted to determine the efficacy of our treatment proposal. Our surgical treatment included an ankle fusion and concomitant flat foot reconstruction with a medializing calcaneal osteotomy, lengthening calcaneal osteotomy, and flexor digitorum longus transfer...

No abstract text is available yet for this article.

The subtle cavus foot alignment is associated with many injuries occurring in the athletic population, most commonly ankle instability and lateral foot overload. Although correction of the primary injury may address the manifestations of the subtle cavus foot, it does not change the alignment. Without recognition of this alignment, the injury likely will recur. The goal is to recognize the posture of the subtle cavus, treat the cavus and the injury, and prevent future recurrence.

This study investigated the use of a custom cavus foot orthosis (CFO) in the treatment of ankle instability and pain associated with the subtle cavus foot, a common pathological foot alignment in the United States population. Patients referred by a single orthopedic foot and ankle surgeon to a single pedorthotist for a CFO over a 2-year period were eligible. Pain score pre-and postorthosis and number of instability events pre- and postorthosis were retrospectively evaluated. Ninety-three of 174 eligible patients participated...

BACKGROUND: Osteonecrosis of the talar body is a challenging problem for both patient and surgeon. One reconstruction option is an arthrodesis of the tibia to the talar neck, as described by Blair, which has the theoretical advantages of salvaging some hindfoot height and motion of the subtalar joint. A few case series have been published describing outcome after modified Blair fusions, none with validated functional outcomes. The purpose of this article is to describe a modification of Blair's original technique, and report the functional outcomes in a series of patients undergoing this procedure...

Hindfoot malalignment and chronic lateral ankle instability may lead to degenerative ankle arthritis. We retrospectively analyzed 10 patients with 13 cavovarus feet. None of the patients had underlying neurologic disorders. All patients presented with a history consistent with chronic lateral ankle instability, clinically with cavovarus feet, and radiographically with varying degrees of varus talar tilt and ankle arthritis. Ankles with severe degenerative change were fused. The ankles with mild or moderate change underwent calcaneal osteotomy with lateral ligament reconstruction and/or dorsiflexion osteotomy of the first metatarsal...