MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Foot and Ankle Clinics' source. Thu, 09 Feb 2012 00:02:28 +0100 http://www.medworm.com/index.php?rid=5650959&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751512000095%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650959 Fri, 03 Feb 2012 04:48:22 +0100 5650959 http://www.medworm.com/index.php?rid=5650951&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511001057%2Fabstract%3Frss%3Dyes To our knowledge, little is reported about the management of the patients with combined symptomatic osteochondral lesions of the talus (OLT) and varus ankle malalignment. Treatment strategies for symptomatic OLTs are relatively well described in the orthopaedic literature. While less defined than the surgical management of OLTs, realignment procedures for the varus ankle and hindfoot have also been studied and reported in some detail, albeit with a focus on management of ankle arthritis. In this article we review practical concepts from the orthopaedic literature that may be applied when treating patients with concomitant OLTs and varus ankles malalignment. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650951 Fri, 03 Feb 2012 04:48:22 +0100 5650951 http://www.medworm.com/index.php?rid=5650947&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751512000083%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650947 Fri, 03 Feb 2012 04:48:22 +0100 5650947 http://www.medworm.com/index.php?rid=5650946&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751512000071%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650946 Fri, 03 Feb 2012 04:48:22 +0100 5650946 http://www.medworm.com/index.php?rid=5650945&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151200006X%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650945 Fri, 03 Feb 2012 04:48:22 +0100 5650945 http://www.medworm.com/index.php?rid=5650957&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511001033%2Fabstract%3Frss%3Dyes The unique anatomy of the talus contributing to three important joints makes its integrity and joint congruency crucial for normal foot function. Consequently, posttraumatic malalignment of the talus with resultant deformity almost invariably leads to painful functional impairment. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650957 Mon, 26 Dec 2011 05:00:00 +0100 5650957 http://www.medworm.com/index.php?rid=5650958&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511001021%2Fabstract%3Frss%3Dyes VMAA is common in end-stage ankle arthritis with varying and poorly described etiologies. With a greater understanding of VMAA, it is becoming apparent that its pathology has both hereditary and environmental factors that follow several different pathways, all resulting in a varus coronal plane deformity of the talus. Multiple surgical methods to correct VMAA have been proposed, based primarily on the degree of deformity in the coronal plane. However, focusing exclusively on the talar coronal plane deformity is an oversimplification of a complex problem. The multidimensional nature of VMAA needs to be appreciated by the treating surgeon such that appropriate interventions can be planned in advance of the surgery. The purpose of this article is to describe the current understanding of the v... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650958 Wed, 14 Dec 2011 05:00:00 +0100 5650958 http://www.medworm.com/index.php?rid=5650954&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000957%2Fabstract%3Frss%3Dyes The focus of this article is the correction of distal tibial varus deformities utilizing gradual techniques and distraction osteogenesis. Distraction osteogenesis is the formation of new bone after an osteotomy is completed using tension-lengthening techniques. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650954 Wed, 14 Dec 2011 05:00:00 +0100 5650954 http://www.medworm.com/index.php?rid=5650953&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000969%2Fabstract%3Frss%3Dyes Hindfoot varus has been recognized as an anatomic risk factor that promotes chronic lateral ankle instability. Hindfoot varus is present in 8% of patients with ankle instability, and with 28% it is the most commonly found condition in patients with persisting pain or recurrent instability after lateral ankle ligament reconstruction. Varus malalignment may occur isolated at a single structural level (eg, supramalleolar) or as part of a complex deformity with multiple structures involved (eg, cavovarus deformity). In order to select the optimal treatment strategy, a thorough understanding of the static and dynamic causes of deformity and their biomechanical effects is mandatory. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650953 Wed, 14 Dec 2011 05:00:00 +0100 5650953 http://www.medworm.com/index.php?rid=5650950&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000994%2Fabstract%3Frss%3Dyes Varus malalignment of the distal lower extremity can be a challenging condition to treat. The spectrum of involvement of the cavus foot may range from a mildly elevated longitudinal arch in an otherwise functional foot to completely rigid deformities in patients with secondary arthritis, stress fractures, muscle weakness, and ligamentous insufficiency. Patients often present with pain secondary to increased stresses on one part of the foot. For instance, patients with Charcot-Marie-Tooth disease may overload the lateral border of the foot, the first metatarsal head, or the lateral metatarsal heads. This increased load may result in stress fractures, particularly affecting the fifth metatarsal. In athletes, this foot shape results in increased load on the metatarsal heads and on the calcane... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650950 Mon, 12 Dec 2011 05:00:00 +0100 5650950 http://www.medworm.com/index.php?rid=5650948&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511001045%2Fabstract%3Frss%3Dyes I would like to say thank you to everybody involved in this edition. First, I would like to thank Mark Myerson for inviting me to do this edition. Mark should be recognized also for his tireless devotion to Foot and Ankle Clinics. To keep working away the way he does getting these high-quality articles out year after year deserves special mention. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650948 Mon, 12 Dec 2011 05:00:00 +0100 5650948 http://www.medworm.com/index.php?rid=5650955&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100101X%2Fabstract%3Frss%3Dyes The most common cause of end-stage ankle arthritis is trauma. Factors contributing to the development of posttraumatic ankle arthritis are the initial cartilage damage, malreduction, nonunion, infections, and instability. In a retrospective study, Valderrabano and colleagues found that 55% of patients with posttraumatic ankle arthritis presented with a varus malalignment, whereas 8% had valgus malalignment. Malalignment leads to altered load distribution across the joint, interfering with normal cartilage metabolism. In young patients this interference can lead to early ankle joint arthritis, for which ankle fusion or joint replacement may not provide a lifetime solution. Therefore, supramalleolar osteotomies have gained increasing popularity to address sequelae of posttraumatic ankle join... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650955 Thu, 08 Dec 2011 05:00:00 +0100 5650955 http://www.medworm.com/index.php?rid=5650952&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000970%2Fabstract%3Frss%3Dyes This article reviews and updates the etiology, characteristics, and management of the hindfoot varus originating from neurologic disorders. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650952 Tue, 06 Dec 2011 05:00:00 +0100 5650952 http://www.medworm.com/index.php?rid=5650956&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000982%2Fabstract%3Frss%3Dyes The technology and techniques of total ankle replacement have improved significantly over the last few decades. With these advances, the indications for ankle replacement have similarly expanded. Previously, ankle replacement was primarily indicated for patients with minimal coronal plane deformity. This excluded many patients from ankle replacement, because the most common pathology leading to ankle replacement is posttraumatic arthritis and this is frequently associated with a varus deformity. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650956 Mon, 05 Dec 2011 05:00:00 +0100 5650956 http://www.medworm.com/index.php?rid=5650949&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000945%2Fabstract%3Frss%3Dyes Varus deformity implies angulation toward the midline of the distal segment of bone or joint. Because the foot is at a right angle to the long axis of the leg, use of the term in the foot may be confusing. Varus of the ankle refers to a varus plafond or varus tilt of the talus in the mortise. Varus of the hindfoot refers to angulation toward the midline of the longitudinal axis of the calcaneal tuberosity and may also be referred to as supination, or inversion of the subtalar joint. Varus of the forefoot refers to elevation of the medial ray and may also be referred to as supination or inversion of the plane of the metatarsal heads relative to the hindfoot (). Varus deformity of the foot and ankle is common and embodies a spectrum of anatomic variations from mild to severe, and in many cas... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5650949 Fri, 02 Dec 2011 05:00:00 +0100 5650949 http://www.medworm.com/index.php?rid=5450835&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100088X%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450835 Mon, 28 Nov 2011 17:14:34 +0100 5450835 http://www.medworm.com/index.php?rid=5450834&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000763%2Fabstract%3Frss%3Dyes A tailor's bunion or bunionette deformity is a combination of an osseous and soft-tissue bursitis located on the lateral aspect of the fifth metatarsal head and was first described by Davies as a condition caused by splaying of the fifth metatarsal. The condition is often present with hallux valgus deformity, both of which are noted with a flexible splayfoot (). (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450834 Mon, 28 Nov 2011 17:14:34 +0100 5450834 http://www.medworm.com/index.php?rid=5450833&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000568%2Fabstract%3Frss%3Dyes Bunionette is a term used to characterize a lateral prominence of the fifth metatarsal head. Also known as a “tailor's bunion,” due to the cross-legged position of a tailor, the bunionette deformity usually consists of both an abnormal fifth metatarsal as well as overlying soft tissues. Bunionettes can occur in many individuals and are often noted as incidental findings. Very rarely do these become significant enough to warrant treatment. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450833 Mon, 28 Nov 2011 17:14:34 +0100 5450833 http://www.medworm.com/index.php?rid=5450832&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000751%2Fabstract%3Frss%3Dyes Congenital deformities of the lesser toes are relatively uncommon, but when present can prove challenging to the clinician. Congenital lesser toe deformities may not cause significant pain or functional problems, but often cause patient anxiety over their appearance. Marked enlargement or deviation of lesser toes can cause problems with shoe wear or painful impingement of the digits. Nonoperative care focuses on the use of wide toe box footwear to provide sufficient space for the digits. In cases with transfer metatarsalgia, a prescription orthotic insole with a cushioned forefoot and a metatarsal pad may relieve pressure. Surgical treatment is performed in some cases for cosmetic reasons, but more often is recommended to alleviate painful symptoms or shoe wear difficulties. In this articl... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450832 Mon, 28 Nov 2011 17:14:34 +0100 5450832 http://www.medworm.com/index.php?rid=5450830&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000799%2Fabstract%3Frss%3Dyes A patient once said that her father told her that, “To forget all your troubles you only need to wear a pair of tight shoes.” Tight shoes, as even children know, have also been blamed for extreme personality disorders and failure to embrace the Christmas spirit:The Grinch hated Christmas! The whole Christmas season!Now, please don't ask why. No one quite knows the reason.It could be his head wasn't screwed on just right.It could be, perhaps, that his shoes were too tight.From “How the Grinch stole Christmas!” (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450830 Mon, 28 Nov 2011 17:14:34 +0100 5450830 http://www.medworm.com/index.php?rid=5450827&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000623%2Fabstract%3Frss%3Dyes Metatarsalgia is among the most common sources of pain in the human body. Some use the term broadly to refer to a number of painful conditions in the forefoot. However, metatarsalgia has been differentiated from other forefoot conditions and is defined as pain across the plantar forefoot beneath the second, third, and fourth metatarsal heads. The many causes of metatarsalgia can be categorized in 3 groups: (1) Local disease in the region (eg, interdigital neuroma), (2) altered forefoot biomechanics (clawtoe, hallux rigidus), and (3) systemic disease affecting the region (rheumatoid arthritis). (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450827 Mon, 28 Nov 2011 17:14:34 +0100 5450827 http://www.medworm.com/index.php?rid=5450826&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000581%2Fabstract%3Frss%3Dyes Hammer toes are flexion deformities of the proximal interphalangeal (PIP) joint and are often associated with ill-fitting shoe wear. Less commonly they can be attributed to congenital and neuromuscular conditions. Multiple factors contribute to the development of this deformity, but prevalence is higher in women and with advanced age. The dorsal aspect of the PIP joint is most commonly painful because of pressure or shearing within the toe box of the shoe (). Pain at the distal-most aspect of the toe may also occur from rubbing against the insole. More severe deformities may hinder the plantar flexion power of the toe, resulting in metatarsalgia. Patients with peripheral neuropathy are at increased risk for ulcer formation over the dorsal PIP joint and distal toe. (Source: Foot and Ankle C... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450826 Mon, 28 Nov 2011 17:14:34 +0100 5450826 http://www.medworm.com/index.php?rid=5450824&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100074X%2Fabstract%3Frss%3Dyes Lesser toe deformities are a common complaint. Lesser toe pathology can be erroneously considered a minor problem, because pain and deformity can have a significant impact on a patient's quality of life. Hammertoes and clawtoes are the most common deformity; surgical management of these deformities is among the most common procedures performed on the forefoot. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450824 Mon, 28 Nov 2011 17:14:34 +0100 5450824 http://www.medworm.com/index.php?rid=5450821&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000878%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450821 Mon, 28 Nov 2011 17:14:34 +0100 5450821 http://www.medworm.com/index.php?rid=5450820&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000933%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450820 Mon, 28 Nov 2011 17:14:34 +0100 5450820 http://www.medworm.com/index.php?rid=5450819&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000866%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450819 Mon, 28 Nov 2011 17:14:34 +0100 5450819 http://www.medworm.com/index.php?rid=5450829&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000787%2Fabstract%3Frss%3Dyes Because of its position next to the hallux, relative length of the second metatarsal, and limited motion at the second tarsometatarsal joint, pain, inflammation, and subluxation are common problems of the second metatarsophalangeal (MTP) joint. Crossover toe typically occurs when the second toe deviates medially and dorsally over the hallux, leaving an increased space between the second and third toes (). It also is common to see the second toe deviate laterally into a valgus deformity, often owing to a hallux valgus deformity and pressure from the great toe. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450829 Wed, 19 Oct 2011 04:00:00 +0100 5450829 http://www.medworm.com/index.php?rid=5450823&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100057X%2Fabstract%3Frss%3Dyes Mallet toe is defined as flexion of the distal phalanx over the middle phalanx due to a contracture at the distal interphalangeal joint (DIPJ) (). The term was first coined by Lake in the orthopedic literature. A mallet toe apart from a sagittal plane deformity described here may also have medial or lateral deviation of the distal phalanx. There is confusion in the orthopedic literature over the definition of the lesser toe deformities, particularly the common ones of hammer toe, clawtoe, and mallet toe. This confusion was shown in a study among Dutch orthopedic surgeons in which there was a lack of consensus in definition and treatment strategies. Although lesser toe surgery is commonly performed, level I evidence and prospective studies are lacking to help determine which procedure is th... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450823 Wed, 19 Oct 2011 04:00:00 +0100 5450823 http://www.medworm.com/index.php?rid=5450831&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000611%2Fabstract%3Frss%3Dyes Originally described in 1914, Freiberg reported on a series of 6 cases with a similar “infarction” pattern of the second metatarsal head. This pattern resulted in flattening and collapse of the head, with subsequent degenerative changes of the metatarsophalangeal (MTP) joint and ultimate arthritis in the final stages. Since then, numerous descriptions of the disease and opinions regarding its causes have been proposed. Although considered an uncommon occurrence, avascular necrosis of the second metatarsal is the fourth most common osteochondrosis. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450831 Mon, 17 Oct 2011 04:00:00 +0100 5450831 http://www.medworm.com/index.php?rid=5450822&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000817%2Fabstract%3Frss%3Dyes The lesser toes contribute to normal function of the forefoot and to propulsive gait. Disorders of these toes can be difficult for the patient and surgeon alike. Patients suffer pain, dysfunction, and difficulty with footwear, all hallmarks of lesser toe pathology. Surgeons also find these problems troubling, with seemingly simple surgeries complicated by recurrent pain, deformity, and patient dissatisfaction. This issue of Foot and Ankle Clinics explores various conditions, considering etiology, evaluation, nonoperative treatment, and surgical options for the lesser toes. A panel of international authors provides outcomes-based recommendations along with personal experience and practical tips to assist the reader in treating these difficult problems. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450822 Mon, 17 Oct 2011 04:00:00 +0100 5450822 http://www.medworm.com/index.php?rid=5450828&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100060X%2Fabstract%3Frss%3Dyes Metatarsalgia is a generic term, derived from the Greek, to describe pain in the forefoot. It is generally accepted to mean pain that is felt around the plantar aspects of the lesser metatarsal heads but it does not give any specific clue as to the cause of the pain or how best to treat it. The various causes of metatarsalgia can be broadly classified as local, biomechanical, or systemic abnormalities, and a careful history and examination of the patient is required to ascertain exactly which part of the forefoot is involved and to elucidate which contributory factors exist. Metatarsalgia is a common complaint that is frequently seen in patients attending a foot and ankle clinic. Patients often describe the symptoms by saying that they feel like they are walking on “marbles” or with a ... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450828 Mon, 10 Oct 2011 04:00:00 +0100 5450828 http://www.medworm.com/index.php?rid=5450825&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000593%2Fabstract%3Frss%3Dyes Despite their size and location at the distal extremities, the lesser toes can be a major source of discomfort and pain for patient and surgeon alike, and symptoms may be overlooked or underestimated. Commonly patients present with rather nonspecific symptoms, unable to locate accurately the exact site of pain or disability. Understanding the anatomy and potential pathology is crucial, along with careful history taking and examination, to identify the underlying problem. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5450825 Wed, 05 Oct 2011 04:00:00 +0100 5450825 http://www.medworm.com/index.php?rid=5240848&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000702%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240848 Thu, 01 Sep 2011 04:00:00 +0100 5240848 http://www.medworm.com/index.php?rid=5240847&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000532%2Fabstract%3Frss%3Dyes Spastic equinovarus (SEV) foot deformity is common in patients with upper motor neuron syndrome (UMNS) following stroke and traumatic brain injury. UMNS is characterized by muscle weakness, spasticity (an exaggerated response to a quick stretch stimulus), associated movements (synkinesis), and abnormal patterns of muscle activation. The equinovarus posture of the foot causes significant problems with shoe wear, standing, transfers, and walking (). The deformity often cannot be managed with nonsurgical treatments such as chemodenervation, orthoses, and physical therapy. In fact, these nonsurgical treatment modalities, when attempted for long periods of time, are more costly and less effective than surgical treatment. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240847 Thu, 01 Sep 2011 04:00:00 +0100 5240847 http://www.medworm.com/index.php?rid=5240844&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000490%2Fabstract%3Frss%3Dyes Hallux varus can occur for a variety of reasons. It most commonly occurs as an iatrogenic deformity after bunion correction. Less commonly, it is the result of inflammatory or neurologic processes, such as rheumatoid arthritis or Charcot–Marie–Tooth disease. Trauma may also result in this deformity. Generally, hallux varus is thought of as a cosmetic deformity, but in some cases it can interfere with shoe wear or cause pain. In these cases, surgical correction is warranted. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240844 Thu, 01 Sep 2011 04:00:00 +0100 5240844 http://www.medworm.com/index.php?rid=5240843&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000544%2Fabstract%3Frss%3Dyes Correction of the adult cavovarus foot deformity, whether rigid or flexible, can be quite challenging. While there are many causes of this deformity, the universal problem is the loss of muscle balance around the ankle and foot. If left untreated, progression of deformity is inevitable as a result of this imbalance, and generally the flexible deformity ultimately becomes rigid. It makes sense therefore, to commence treatment as early as possible in order to preserve as much mobility as possible. While this is clearly worthwhile, this goal is not always realistic, since many patients are not symptomatic and manage their activities of daily living even without orthotic or brace support. However, when surgery is indicated, the goal has to be to obtain a plantigrade and balanced foot, and this... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240843 Thu, 01 Sep 2011 04:00:00 +0100 5240843 http://www.medworm.com/index.php?rid=5240842&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000477%2Fabstract%3Frss%3Dyes The “bridle” procedure is a modification of the transfer of the tibialis posterior to the dorsum of the foot for the treatment of a supple equinus or equinovarus deformity of the ankle and hindfoot. It consists of a transfer of the posterior tibial tendon through the interosseous membrane to the dorsum of the foot with concomitant anastomosis to the anterior tibial and peroneus longus tendons. It is indicated primarily in the setting of a drop-foot and a steppage gait, which is awkward, energy consuming, and physically limiting. In affected patients, even a partial correction of this gait pattern may decrease or eliminate the need for bracing. This can be of great benefit, especially if other disabilities accompany the loss of ankle dorsiflexion. In patients who have even limited lower... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240842 Thu, 01 Sep 2011 04:00:00 +0100 5240842 http://www.medworm.com/index.php?rid=5240841&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000520%2Fabstract%3Frss%3Dyes This article describes the etiologies, evaluation, and operative management of equinovarus deformity in adults and pediatric populations by tendon transfer and ancillary soft tissue releases. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240841 Thu, 01 Sep 2011 04:00:00 +0100 5240841 http://www.medworm.com/index.php?rid=5240840&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000465%2Fabstract%3Frss%3Dyes Tendon transfers are an invaluable tool that may be used for a variety of purposes in foot and ankle surgery. They allow for the correction of deformity, establishment or augmentation of motor function, or the generation of a tenodesis effect. These procedures are especially effective for correcting supple deformities caused by dynamic muscular imbalance. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240840 Thu, 01 Sep 2011 04:00:00 +0100 5240840 http://www.medworm.com/index.php?rid=5240839&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000453%2Fabstract%3Frss%3Dyes The foot is the unique end organ of weight bearing that functions as an essential component of normal efficient walking. It has an adaptable bony architecture that allows prepositioning of its durable plantar soft tissue envelope in a plantigrade position to accept the impact of loading. It is then capable of transitioning during stance phase from the pressure-dissipating unlocked position at heel strike to the locked position at push-off that optimizes stable propulsion. Underactivity or overactivity of the motors that drive this process leads to inefficiency and/or instability during walking. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240839 Thu, 01 Sep 2011 04:00:00 +0100 5240839 http://www.medworm.com/index.php?rid=5240838&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000556%2Fabstract%3Frss%3Dyes Tendon transfers have been an invaluable part of the orthopedic armamentarium for more than a century. These procedures have great utility in correcting deformity, establishing or augmenting motor function, and generating a tenodesis effect. As such, they have become some of the most frequently performed orthopedic foot and ankle surgeries. Their success provides great satisfaction to both patient and surgeon alike. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240838 Thu, 01 Sep 2011 04:00:00 +0100 5240838 http://www.medworm.com/index.php?rid=5240837&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000519%2Fabstract%3Frss%3Dyes The uses of tendon transfers is a fascinating topic. Although we do not treat as many paralytic deformities as were corrected surgically in the era of polio, there are many circumstances where tendon transfers remain an essential part of the operative management of deformity. The correction of foot and ankle deformity by means of a correctly performed tendon transfer can be satisfying for both the surgeon and the patient. The goal of any tendon transfer is to create a stable, functioning, and plantigrade foot, and this goal applies to every tendon transfer performed for paralysis because the correction of deformity, the improvement of function, and the establishment of a plantigrade foot are essential. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240837 Thu, 01 Sep 2011 04:00:00 +0100 5240837 http://www.medworm.com/index.php?rid=5240836&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000696%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240836 Thu, 01 Sep 2011 04:00:00 +0100 5240836 http://www.medworm.com/index.php?rid=5240835&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000684%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240835 Thu, 01 Sep 2011 04:00:00 +0100 5240835 http://www.medworm.com/index.php?rid=5240834&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000672%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240834 Thu, 01 Sep 2011 04:00:00 +0100 5240834 http://www.medworm.com/index.php?rid=5240846&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000489%2Fabstract%3Frss%3Dyes Equinovalgus deformity of the paralytic foot is not commonly seen, but does present occasionally. It is as a result of specific muscle imbalances, consisting of an unopposed activity of the everters (peroneal tendons) relative to the inverters (tibialis posterior and tibialis anterior tendons). Thus, this deformity is only seen when both the posterior and the anterior tibial muscles become nonfunctioning. There is very little in the literature regarding this deformity as a specific entity. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240846 Tue, 16 Aug 2011 04:00:00 +0100 5240846 http://www.medworm.com/index.php?rid=5240845&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000507%2Fabstract%3Frss%3Dyes The Girdlestone flexor-to-extensor transfer was first described by Taylor in 1951. He described a technique whereby transferring the toe flexors to the dorsum of the proximal phalanx, one “restores useful function to the toes at the cost of their prehensile action.” Taylor attributed the inspiration for the procedure to the hand surgery literature, where flexor digitorum superficialis tendons had been successfully transferred to enhance intrinsic function. The effort to convert the action of the toe flexors into that of intrinsic muscles can also be seen in a case report published by Lambrinudi in 1928. Lambrinudi reports performing interphalangeal joint fusions and extensor tenotomies in the toes of a 12-year-old with claw toes. The goal was to reduce the 4-bone metatarsophalangeal (M... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=5240845 Tue, 16 Aug 2011 04:00:00 +0100 5240845 http://www.medworm.com/index.php?rid=4834695&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000374%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834695 Thu, 19 May 2011 14:34:08 +0100 4834695 http://www.medworm.com/index.php?rid=4834694&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100026X%2Fabstract%3Frss%3Dyes Complex regional pain syndrome (CRPS) is a challenging pain condition for doctors and patients, with a natural history characterized by chronicity and relapses that can result in significant disability. CRPS is difficult to diagnose and treat, and requires close follow-up to ensure that progress is being made. Early diagnosis and treatment are required to prevent a long-standing or permanent disability. Clinical features such as spontaneous pain, edema, hyperalgesia, temperature or sudomotor changes, motor function abnormality, and autonomic changes are the hallmark of this disease. The treatment of CRPS remains controversial, and includes medications, physical therapy, regional anesthesia, and neuromodulation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834694 Thu, 19 May 2011 14:34:07 +0100 4834694 http://www.medworm.com/index.php?rid=4834693&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000039%2Fabstract%3Frss%3Dyes Diabetic peripheral neuropathy likely affects up to one-third of adults with diabetes. All diabetic patients are likely to develop peripheral neuropathy if they live sufficiently long. Recognition is crucial for initiation of the preventive strategies that have been demonstrated to decrease the potential risk for the development of diabetic foot ulcers, foot infection, Charcot foot, or amputation. The mainstay of current treatment is optimal glucose and hemoglobin A1C control. Drug therapy has limited potential for controlling the associated pain. Alternative methods of treatment have thus far demonstrated limited success. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834693 Thu, 19 May 2011 14:34:07 +0100 4834693 http://www.medworm.com/index.php?rid=4834691&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000027%2Fabstract%3Frss%3Dyes Nerve scarring can cause severe pain and dysfunction. Treatment of the scarred nerve frequently yields unpredictable results. A barrier wrap around the scarred nerve could be of benefit in preventing the recurrence of epineural scarring following neurolysis. The barrier would ideally be inert so as to not incite an inflammatory response, and be nondegradable. Veins fulfill both of these objectives. The desirable qualities of a barrier nerve wrap include a substance that decreases nerve scarring, does not constrict and thus compress the nerve, and improves nerve gliding. The primary indication for nerve wrapping is a nerve with adherent scar. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834691 Thu, 19 May 2011 14:34:07 +0100 4834691 http://www.medworm.com/index.php?rid=4834690&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000040%2Fabstract%3Frss%3Dyes Recurrent or persistent symptoms following surgical neurectomy for an interdigital neuroma are quite common, because of incorrect initial diagnosis, true neuroma formation, nerve stump adhesions, accessory nerve branches, or an adjacent web space neuroma. The clinical presentation of a recurrent neuroma is similar to the initial presentation. Recurrent symptoms usually occur within the first 12 months after surgery. The physical examination coupled with diagnostic nerve blocks is critical for diagnosis. Conservative therapy, although not particularly effective in treating true recurrent neuromas, may help to alleviate pain. With proper isolation of the instigating neuroma, revision surgical excision can be effective. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834690 Thu, 19 May 2011 14:34:07 +0100 4834690 http://www.medworm.com/index.php?rid=4834689&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000222%2Fabstract%3Frss%3Dyes Interdigital neuralgia affects a significant number of individuals, with an average age of presentation in the sixth decade and a 4- to 15-fold increased prevalence in women. Historical descriptions date back to the 19th century. Nonoperative treatment with shoe modifications, metatarsal pads, and injections provides relief for most, but long term, 60% to 70% of patients eventually elect to have surgery. Although excision can be performed through a dorsal or plantar approach, we prefer the dorsal incision to prevent scar formation on the plantar aspect of the foot. Satisfactory results are common but not certain with reports of excellent or good ranging from 51% to 93%. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834689 Thu, 19 May 2011 14:34:07 +0100 4834689 http://www.medworm.com/index.php?rid=4834687&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000271%2Fabstract%3Frss%3Dyes Failed surgical releases of the tarsal tunnel may be due to numerous causes. Many of the failures are due to lack of appreciation of the involved anatomy or inadequate technique. When an insufficient release is done, a revision simply completes the necessary steps. When external scarring is the problem, barrier materials may be used to help protect the nerve after neurolysis. When intrinsic damage is the problem, nerve wrapping, reconstruction, conduits, and nerve stimulators all play a role to restore function or ameliorate pain. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834687 Thu, 19 May 2011 14:34:07 +0100 4834687 http://www.medworm.com/index.php?rid=4834686&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000209%2Fabstract%3Frss%3Dyes Tarsal tunnel syndrome, unlike its similar sounding counterpart in the hand, is a significantly misunderstood clinical entity. Confusion concerning the anatomy involved, the presenting symptomatology, the appropriateness and significance of various diagnostic tests, conservative and surgical management, and, finally, the variability of reported results of surgical intervention attests to the lack of consensus surrounding this condition. The terminology involved in various diagnoses for chronic heel pain is also a hodgepodge of poorly understood entities. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834686 Thu, 19 May 2011 14:34:07 +0100 4834686 http://www.medworm.com/index.php?rid=4834685&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000180%2Fabstract%3Frss%3Dyes Peripheral nerve entrapments are a relatively rare and heterogeneous group of nerve disorders encompassing a wide variety of etiologies and clinical presentations. These conditions can present significant diagnostic challenges, owing to both the variety of symptoms these patients display, along with the anatomic variation that exists between individuals. Precise knowledge of the anatomic course, the common motor and sensory distributions of each of the peripheral nerves, and judicious use of imaging or electrodiagnostic testing can greatly assist in arriving at a correct diagnosis. In this article, we discuss in detail the anatomy, clinical presentation, diagnosis, and treatment options for peripheral nerve entrapments of the lower extremity involving the sural, saphenous and common, super... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834685 Thu, 19 May 2011 14:34:07 +0100 4834685 http://www.medworm.com/index.php?rid=4834684&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000210%2Fabstract%3Frss%3Dyes The article provides an overview of management and repair strategies for lower extremity peripheral nerve injuries. It discusses the indications for autografts, nerve conduits, allografts, end-to-side repairs, primary repair, and nerve transfers. The relative pros and cons of each strategy are discussed, providing a broad overview of treatment options for the management of lower extremity nerve injuries. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834684 Thu, 19 May 2011 14:34:06 +0100 4834684 http://www.medworm.com/index.php?rid=4834683&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000246%2Fabstract%3Frss%3Dyes This article focuses on the electrodiagnostic evaluation of neurogenic processes that present as foot and ankle symptoms. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834683 Thu, 19 May 2011 14:34:06 +0100 4834683 http://www.medworm.com/index.php?rid=4834682&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000283%2Fabstract%3Frss%3Dyes Neuropathies can be a cause of chronic foot and ankle pain. The diagnosis can be elusive given the sometimes nonspecific clinical presentation. Although electrodiagnostic studies are primarily relied on for the diagnosis of nerve impairment, imaging is sometimes helpful in helping define the exact site of the entrapment and whether any masses are present. It is critical for the imager to understand the complex anatomy of these nerves and their adjacent structures, to know the most common locations for their entrapments or injury, and to select the proper imaging modality to improve detection of these difficult-to-diagnose clinical conditions. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834682 Thu, 19 May 2011 14:34:06 +0100 4834682 http://www.medworm.com/index.php?rid=4834681&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000192%2Fabstract%3Frss%3Dyes Neurogenic problems of the foot and ankle are far more common than often appreciated. From well-known conditions such as Morton neuroma and tarsal tunnel syndrome to peripheral neuropathy, the foot is a frequent target for issues related to the peripheral nervous system, as well as those of the central nervous system. This issue of Foot and Ankle Clinics of North America does not deal with the central nervous system and the manifestations of stroke, cerebral palsy, muscular dystrophy, Parkinson disease, or multiple sclerosis, but it should be noted that orthopedic foot and ankle surgeons must be cognizant of how to diagnose and treat them, as well as the roles of medication, physical medicine, rehabilitation, orthotics, and the use of judicious surgery in the care of these patients. (Sourc... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834681 Thu, 19 May 2011 14:34:06 +0100 4834681 http://www.medworm.com/index.php?rid=4834680&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000295%2Fabstract%3Frss%3Dyes This issue on Nerve Problems of the Lower Extremity, which focuses primarily on the foot and ankle, is an update on the latest approaches to the diagnosis and management of the nerve disorders that we as orthopedic specialists in the foot and ankle encounter in our academic and private practices. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834680 Thu, 19 May 2011 14:34:06 +0100 4834680 http://www.medworm.com/index.php?rid=4834679&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000362%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834679 Thu, 19 May 2011 14:34:06 +0100 4834679 http://www.medworm.com/index.php?rid=4834678&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000350%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834678 Thu, 19 May 2011 14:34:06 +0100 4834678 http://www.medworm.com/index.php?rid=4834677&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000349%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834677 Thu, 19 May 2011 14:34:06 +0100 4834677 http://www.medworm.com/index.php?rid=4834688&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000052%2Fabstract%3Frss%3Dyes Treatment of neuromas in the foot and ankle is evolving. A paucity of studies deals with neuromas in this region; most knowledge comes from hand surgery. A trend toward reconstructive surgery using nerve grafts and conduits for nerves with critical function is being seen. For noncritical nerves, generally accepted treatment is neuroma resection and burial into a tissue bed. A clear knowledge of neural anatomy is paramount, together with correct identification of all the nerves involved in the pain-generation process. More studies dealing with neuromas in this area are needed for evidence-based information. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834688 Thu, 21 Apr 2011 23:00:00 +0100 4834688 http://www.medworm.com/index.php?rid=4834692&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000234%2Fabstract%3Frss%3Dyes Treatment of the chronic painful nerve by pedicled or free tissue transfer is a complex surgical procedure, requiring specialized microsurgical training and technique. This procedure is indicated only in patients who have had repeated failure of simpler, conventional procedures. Patients with chronic painful peripheral nerves may be potentially salvaged by external neurolysis and circumferential wrapping of the involved segments of nerve with well-vascularized pedicled or free flaps of fascia, subcutaneous fatty tissue, omentum or muscle, or by the replacement of superficial hypersensitive cutaneous areas and nerves with the same tissues. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4834692 Sun, 17 Apr 2011 23:00:00 +0100 4834692 http://www.medworm.com/index.php?rid=4584931&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000143%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584931 Tue, 01 Mar 2011 00:00:00 +0100 4584931 http://www.medworm.com/index.php?rid=4584930&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000975%2Fabstract%3Frss%3Dyes The use of a spherical femoral head allograft in conjunction with spherical reaming provides a safe and effective technique for the management of a massive osseous defect in the hindfoot. This technique presents specific advantages over the standard technique of trapezoidal block allograft and joint preparation by way of flat osteotomies, including increased flexibility and freedom in deformity correction and joint alignment. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584930 Tue, 01 Mar 2011 00:00:00 +0100 4584930 http://www.medworm.com/index.php?rid=4584929&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510001002%2Fabstract%3Frss%3Dyes Massive bone loss following calcaneal fractures is a challenging condition to treat, especially if nonunion is present. Meticulous preoperative examination and imaging are crucial for accurate preoperative planning. If performed, successful outcomes can be achieved with the strategies outlined in this article. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584929 Tue, 01 Mar 2011 00:00:00 +0100 4584929 http://www.medworm.com/index.php?rid=4584928&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151000094X%2Fabstract%3Frss%3Dyes This article includes a thorough literature review as well as an extensive description of these techniques. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584928 Tue, 01 Mar 2011 00:00:00 +0100 4584928 http://www.medworm.com/index.php?rid=4584927&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000938%2Fabstract%3Frss%3Dyes Tibiotalocalcaneal (TTC) arthrodesis is a salvage operation to treat a difficult problem; normal function is not expected with arthrodesis of these 2 major joints. However, in properly selected patients, TTC arthrodesis using intramedullary nailing is an effective technique to reduce pain and improve function. It allows load sharing, provides anatomic alignment, and has the advantage of being able to simultaneously arthrodese both the joints with 1 device. Its use is not without risks, and care must be taken when choosing the insertion site to reduce the risk of neurovascular insult. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584927 Tue, 01 Mar 2011 00:00:00 +0100 4584927 http://www.medworm.com/index.php?rid=4584925&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000987%2Fabstract%3Frss%3Dyes The anatomic compression arthrodesis technique with anterior plate augmentation is an effective technique that results in a high union rate, improved functional outcome, and an acceptable complication rate. This technique can be used for both primary ankle arthrodesis and salvage cases with significant bone loss. The authors believe the anterior plate is a useful complement to standard multiplanar screw fixation, and the increased rigidity provided by the anterior plate effectively counters forces, particularly in the sagittal plane, that may otherwise lead to failure of multiplanar screw constructs. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584925 Tue, 01 Mar 2011 00:00:00 +0100 4584925 http://www.medworm.com/index.php?rid=4584924&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000999%2Fabstract%3Frss%3Dyes Isolated subtalar arthrodesis is well accepted for treatment of pathologic conditions of the subtalar joint associated with pain, instability, and deformity that do not respond to conservative treatment. The most frequent indications are primary talocalcaneal or posttraumatic arthrosis; congenital malformations (coalition); or inflammatory diseases. In the last years, arthroscopic subtalar arthrodesis has become an established technique in treatment of the subtalar arthrosis in the absence of deformities, misalignment and bone loss. As this technique limits soft tissue damages, it may diminish hospitalization days. However, this technique necessitates basic experience in arthroscopy of small joints and knowledge of specific anatomy. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584924 Tue, 01 Mar 2011 00:00:00 +0100 4584924 http://www.medworm.com/index.php?rid=4584922&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000926%2Fabstract%3Frss%3Dyes Triple arthrodesis is largely used to restore painful hindfoot deformity. However, the procedure has been connected to several postoperative complications. Therefore, an isolated fusion of the talonavicular and the subtalar joint through a single medial approach has gained popularity. This “diple” arthrodesis provides effective correction of deformities and reduces the risk of wound healing problems on the lateral side of the foot. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584922 Tue, 01 Mar 2011 00:00:00 +0100 4584922 http://www.medworm.com/index.php?rid=4584921&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000884%2Fabstract%3Frss%3Dyes Based on a high percentage of good results, retrospective studies strongly suggest that isolated talonavicular arthrodesis provides efficient pain relief and functional improvement in case of talonavicular arthritis in rheumatoid arthritis, primary or posttraumatic arthritis, flexible acquired flatfoot deformity, residual dorsolateral subluxation of the talonavicular joint after surgical treatment of clubfoot, and some neurologic disorders. However, prospective trials with rigorous methodology are required to establish evidence of efficacy for this procedure. Well-designed biomechanical studies have demonstrated the key role of the talonavicular joint in the complex hindfoot motion and may serve as baseline for further prospective studies. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584921 Tue, 01 Mar 2011 00:00:00 +0100 4584921 http://www.medworm.com/index.php?rid=4584917&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000951%2Fabstract%3Frss%3Dyes Hallux rigidus leads to a restricted and painful motion at the first metatarsophalangeal (MTP 1) joint. Decision making of the appropriate surgical procedure mainly refers to the stage of hallux rigidus. If conservative measures fail, operative procedures can be taken into consideration. Arthrodesis of the MTP 1 joint is widely accepted as the gold standard for end-stage hallux rigidus. Despite the fusion of a key joint, there is little adverse effect on gait, and weight bearing of the first ray can be restored. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584917 Tue, 01 Mar 2011 00:00:00 +0100 4584917 http://www.medworm.com/index.php?rid=4584916&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000064%2Fabstract%3Frss%3Dyes Arthrodesis of the foot and ankle has been used to treat a variety of neuromuscular and degenerative foot disorders for more than 100 years. Techniques have evolved over time, and well-designed biomechanical studies have provided guidance regarding the desirable ranges of foot alignment during arthrodesis. As contemporary implants have made osseous union more reliable, indications and techniques for the fusion of selected joints have evolved and offer the promise of improved function. Nonetheless, the underlying principles of careful tissue handling, meticulous joint alignment, and attentive aftercare remain important in these complex procedures. The method of fixation must be considered, as this may determine the type of arthrodesis that is required. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584916 Tue, 01 Mar 2011 00:00:00 +0100 4584916 http://www.medworm.com/index.php?rid=4584915&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000131%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584915 Tue, 01 Mar 2011 00:00:00 +0100 4584915 http://www.medworm.com/index.php?rid=4584914&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151100012X%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584914 Tue, 01 Mar 2011 00:00:00 +0100 4584914 http://www.medworm.com/index.php?rid=4584913&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751511000118%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584913 Tue, 01 Mar 2011 00:00:00 +0100 4584913 http://www.medworm.com/index.php?rid=4584920&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000963%2Fabstract%3Frss%3Dyes The goals of midfoot reconstruction are to create a painless, functional, and plantigrade foot, which are generally accomplished with arthrodesis and realignment as indicated. The latter requires not only the correction of midfoot deformity when present, but also coexisting hindfoot and forefoot deformities. Once the initial decisions have been made regarding the need for realignment and which joints to include in the arthrodesis, the surgical plan needs to account for the approach, arthrodesis preparation, order of fixation, and choice of fixation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584920 Tue, 18 Jan 2011 00:00:00 +0100 4584920 http://www.medworm.com/index.php?rid=4584918&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000914%2Fabstract%3Frss%3Dyes Severe bone loss of the first metatarsal is a significant problem in revisional surgery of the first metatarsophalangeal joint either after failed hallux valgus surgery or failed primary arthrodesis. A short first ray leads to pathologic biomechanics of the forefoot, which is treated with interpositional bone block arthrodesis. A ball-in-socket preparation performed with cup-in-cone reamers is the preferred method for modeling of the bone block. An autologous iliac crest bone graft reveals good results by bony integration. Bone block arthrodesis represents a feasible treatment for severe bone loss, leading to good clinical results at midterm follow-up. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584918 Tue, 18 Jan 2011 00:00:00 +0100 4584918 http://www.medworm.com/index.php?rid=4584923&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000902%2Fabstract%3Frss%3Dyes Combined subtalar and naviculocuneiform fusion was successful in restoring the longitudinal medial arch after extended breakdown while preserving the talon avicular joint. This surgical technique was shown to give a reliable fusion and biomechanically stable position of the foot. In this review article, we summarize the medial column procedures for flatfoot deformity and present our surgical technique and results of 10 consecutive patients treated with this method at a minimum 1-year follow-up. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584923 Mon, 03 Jan 2011 00:00:00 +0100 4584923 http://www.medworm.com/index.php?rid=4584926&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000872%2Fabstract%3Frss%3Dyes This article discusses the application of the posterior approach to complete a tibiotalar and tibiotalocalcaneal arthrodesis as well as its use for converting a failed total ankle arthroplasty to an arthrodesis. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584926 Thu, 23 Dec 2010 00:00:00 +0100 4584926 http://www.medworm.com/index.php?rid=4584919&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000896%2Fabstract%3Frss%3Dyes This article focuses on arthrodesis of the first tarsometatarsal joint as the primary intervention to treat hypermobility of the first ray or as a salvage procedure to treat prior failed bunion surgery and provides a concise review including historical perspective, definitions, pathomechanics, and treatment of specific forefoot disorders (ie, hypermobility of the first ray and failed bunion surgery). (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4584919 Fri, 17 Dec 2010 00:00:00 +0100 4584919 http://www.medworm.com/index.php?rid=4153610&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000823%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153610 Thu, 11 Nov 2010 07:12:59 +0100 4153610 http://www.medworm.com/index.php?rid=4153609&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000707%2Fabstract%3Frss%3Dyes This article discusses the various procedures for the surgical correction of the floppy toe deformity. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153609 Thu, 11 Nov 2010 07:12:59 +0100 4153609 http://www.medworm.com/index.php?rid=4153608&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000641%2Fabstract%3Frss%3Dyes Shock wave therapy (SWT) stimulates angiogenesis and osteogenesis. SWT is commonly used to treat soft tissue musculoskeletal conditions such as fasciopathies and tendinopathies. Recent basic science and clinical data suggest that SWT can also be used to treat disorders of bone. Nonunions, avascular necrosis, and delayed healing of stress fractures have all been successfully treated with SWT. Success rates with SWT are equal to those with standard surgical treatment, but SWT has the advantage of decreased morbidity. The procedure is safe, well tolerated, yields few complications, and, typically, can be performed on an outpatient basis. SWT is a viable noninvasive alternative to stimulate healing of bone. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153608 Thu, 11 Nov 2010 07:12:59 +0100 4153608 http://www.medworm.com/index.php?rid=4153607&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000719%2Fabstract%3Frss%3Dyes This article discusses the concept and basic science of PRP, and clinical applications of PRP for the augmentation of bone healing in foot and ankle surgery. The authors also provide a classification system that assesses relative risks for poor bone healing and the need for orthobiologic augmentation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153607 Thu, 11 Nov 2010 07:12:59 +0100 4153607 http://www.medworm.com/index.php?rid=4153605&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000720%2Fabstract%3Frss%3Dyes This article briefly outlines thought processes and techniques for 2 recent options for the surgeon. The Trinity product is a unique combination of allograft bone and allograft stem cells. The beta-tricalcium phosphate and collagen materials provide an excellent scaffold for bone growth; when combined with concentrated bone marrow aspirate, they also offer osteoconductive and osteoinductive as well as osteogenerative sources for new bone formation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153605 Thu, 11 Nov 2010 07:12:58 +0100 4153605 http://www.medworm.com/index.php?rid=4153604&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000744%2Fabstract%3Frss%3Dyes Although the unquestionable value of autologous bone grafting and the analogous value of the reaming by-products in nonunion treatment have been mentioned extensively in the literature, there is ongoing vivid discussion for the treatment of those case scenarios where the fracture nonunion is complicated by other local environment adverse circumstances. The graft expansion with growth factors as the bone morphogenetic proteins (BMPs) offers the possibility to reduce the number of operative procedures, complications, length of hospital stay, and time to union. In this article, we consider the potential clinical scenarios for graft expansion with BMPs. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153604 Thu, 11 Nov 2010 07:12:58 +0100 4153604 http://www.medworm.com/index.php?rid=4153603&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000653%2Fabstract%3Frss%3Dyes This article is another review of clinical application of the use of bone morphogenetic proteins, specifically rhBMP2 Infuse Bonegraft, in the treatment of both acute and chronic fracture and fusion situations. Overall experience is reported with particular detail to the use of biologics in the treatment of problems involving the tibia, foot, and ankle. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153603 Thu, 11 Nov 2010 07:12:58 +0100 4153603 http://www.medworm.com/index.php?rid=4153602&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000665%2Fabstract%3Frss%3Dyes This article reviews the basic science and use of such materials in foot and ankle surgery for conditions related to trauma, tumors, and infection. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153602 Thu, 11 Nov 2010 07:12:57 +0100 4153602 http://www.medworm.com/index.php?rid=4153598&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000811%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153598 Thu, 11 Nov 2010 07:12:57 +0100 4153598 http://www.medworm.com/index.php?rid=4153597&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151000080X%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153597 Thu, 11 Nov 2010 07:12:57 +0100 4153597 http://www.medworm.com/index.php?rid=4153596&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000793%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153596 Thu, 11 Nov 2010 07:12:57 +0100 4153596 http://www.medworm.com/index.php?rid=4153606&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151000063X%2Fabstract%3Frss%3Dyes This article reviews the applicable basic science and mechanisms of action of PDGF, with attention to the increasingly defined role of rhPDGF-BB in initiating bone regeneration. The most recent data from prospective clinical trials evaluating the use of rhPDGF-BB in combination with beta tricalcium phosphate as a substitute for autogenous bone graft in hindfoot and ankle arthrodesis are also summarized. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153606 Mon, 04 Oct 2010 00:00:00 +0100 4153606 http://www.medworm.com/index.php?rid=4153600&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000690%2Fabstract%3Frss%3Dyes This article reviews the key aspects of clinical translation of strategies in tissue engineering as well as current applications and results of BMP use in tibia, foot, and ankle surgery. Future applications of BMP and novel materials in foot and ankle surgery are also reviewed. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153600 Mon, 04 Oct 2010 00:00:00 +0100 4153600 http://www.medworm.com/index.php?rid=4153601&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000677%2Fabstract%3Frss%3Dyes The techniques of proximal and distal tibial bone grafting have been well described in the literature. With the growth of a variety of new bone grafting techniques, the proximal and distal tibial bone sites remain reliable and safe for the retrieval of cancellous graft. These sites, particularly the upper tibia, provide large amounts of cancellous graft with little donor site morbidity. Proximal and distal tibial bone grafting remains a technique against which other grafting techniques should be measured. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153601 Fri, 01 Oct 2010 00:00:00 +0100 4153601 http://www.medworm.com/index.php?rid=4153599&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000732%2Fabstract%3Frss%3Dyes This issue of Foot and Ankle Clinics focuses on the complex issue of bone grafting. While orthopedic surgeons continue to evolve methods of bone fixation and fusion, the variety of bone graft, bone substitutes, and biologic augmentation has exploded. Early in my career, I left the iliac crest, believing the patients’ discomfort from the graft donor site outweighed the benefits. The proximal tibia seemed an ideal source of cancellous bone and some corticocancellous grafts could also be harvested. I sometimes backfilled with allograft and sometimes with bone substitute. With better understanding of orthopedic biology, I have drifted to allograft or bone substitute, augmented by iliac crest bone marrow aspirate. I am a “stem cell believer” and use the Trinity allograft with stem cells w... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=4153599 Fri, 01 Oct 2010 00:00:00 +0100 4153599 http://www.medworm.com/index.php?rid=3811035&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000586%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811035 Tue, 03 Aug 2010 07:27:29 +0100 3811035 http://www.medworm.com/index.php?rid=3811033&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000471%2Fabstract%3Frss%3Dyes Amputations of the lower extremity may result from several etiologic factors. Most amputations performed in the United States result from a dysvascular limb. A majority of the population with vascular impairment comprises people with diabetes. These individuals frequently have comorbidities that may also affect the ultimate outcome of amputation. Loss of protective sensation, propensity toward infection, and visual and balance impairment all create additional issues with postamputation gait in the population with diabetes. Amputations about the foot and ankle affect gait and energy consumption. More gait disturbances tend to be seen as amputation level becomes more proximal; however, loss of the metatarsophalangeal joints has a profound effect, regardless of the proximal level of amputatio... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811033 Tue, 03 Aug 2010 07:27:29 +0100 3811033 http://www.medworm.com/index.php?rid=3811031&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000306%2Fabstract%3Frss%3Dyes This article discusses patient selection, surgical technique, and rehabilitation of an underused rehabilitation amputation level. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811031 Tue, 03 Aug 2010 07:27:29 +0100 3811031 http://www.medworm.com/index.php?rid=3811028&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151000032X%2Fabstract%3Frss%3Dyes This article focuses on the surgical implications of angiosomes of the foot and ankle and their arterial-arterial connections. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811028 Tue, 03 Aug 2010 07:27:29 +0100 3811028 http://www.medworm.com/index.php?rid=3811027&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000288%2Fabstract%3Frss%3Dyes Impaired soft tissue regeneration and delayed osseous healing are known complications associated with diabetes mellitus with regard to orthopedic surgery, making the management and treatment of diabetic patients undergoing foot and ankle surgery more complex and difficult. At the moment several options are available to address the known issues that complicate the clinical outcomes in these high-risk patients. Using a multifaceted approach, with close attention to intraoperative and perioperative considerations including modification of surgical technique to supplement fixation, local application of orthobiologics, tight glycemic control, administration of supplementary oxygen, and biophysical stimulation via low-intensity pulsed ultrasound and electrical bone stimulation, the impediments a... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811027 Tue, 03 Aug 2010 07:27:28 +0100 3811027 http://www.medworm.com/index.php?rid=3811025&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000501%2Fabstract%3Frss%3Dyes This issue of Foot and Ankle Clinics of North America is dedicated to some of the most complex patients seen in an orthopedic practice: diabetics with lower extremity infection. The economic burden of diabetes in the United States may well be as high as $200 billion this year. More than 60,000 diabetics will undergo a lower extremity amputation this year. As many as a third of those will die within 2 years. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811025 Tue, 03 Aug 2010 07:27:28 +0100 3811025 http://www.medworm.com/index.php?rid=3811024&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000574%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811024 Tue, 03 Aug 2010 07:27:28 +0100 3811024 http://www.medworm.com/index.php?rid=3811023&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000562%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811023 Tue, 03 Aug 2010 07:27:28 +0100 3811023 http://www.medworm.com/index.php?rid=3811022&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000550%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811022 Tue, 03 Aug 2010 07:27:28 +0100 3811022 http://www.medworm.com/index.php?rid=3811030&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000318%2Fabstract%3Frss%3Dyes Infections in and around the calcaneus can be quite challenging for the patients and physicians involved. These infections arise because of multiple potential etiologies including chronic pressure, trauma, and postsurgical wound-healing complications. The impediments to healing can be equally as diverse depending on patients' comorbidities, such as smoking, diabetes, and open injury. In this article the authors review the anatomy of the calcaneus and surrounding soft tissue, patient risk factors, and various treatment options that can be used through a multidisciplinary approach. The common limiting factor for most of these patients is the delicate soft-tissue envelope, and occasionally, the lack thereof. The ultimate goal is an infection-free limb with durable soft-tissue coverage and max... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811030 Sun, 27 Jun 2010 23:00:00 +0100 3811030 http://www.medworm.com/index.php?rid=3811032&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151000046X%2Fabstract%3Frss%3Dyes Partial foot amputations are frequently performed to salvage significant portions of the lower extremity affected by limb-threatening infection. Once healed, the residual foot is at high risk for reulceration. Careful long-term follow-up and appropriate interventions can lower this risk. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811032 Wed, 23 Jun 2010 23:00:00 +0100 3811032 http://www.medworm.com/index.php?rid=3811034&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000331%2Fabstract%3Frss%3Dyes This article highlights the roles these specialists play in treating patients with partial foot amputation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811034 Sun, 20 Jun 2010 23:00:00 +0100 3811034 http://www.medworm.com/index.php?rid=3811026&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000276%2Fabstract%3Frss%3Dyes Given the aging population, the number of patients at risk for peripheral arterial disease and critical limb ischemia will increase in the upcoming decade. Using a focused history and physical examination, along with a combination of noninvasive physiologic testing and noninvasive and invasive imaging modalities, one can accurately assess the location and physiologic effect of peripheral arterial disease. This assessment then allows the selection of the most appropriate treatment option for each patient. Treatment options may include exercise and risk-factor modification, amputation, and endovascular or surgical revascularization or a combination of both. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811026 Tue, 08 Jun 2010 23:00:00 +0100 3811026 http://www.medworm.com/index.php?rid=3616775&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000422%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616775 Mon, 31 May 2010 23:00:00 +0100 3616775 http://www.medworm.com/index.php?rid=3616774&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000215%2Fabstract%3Frss%3Dyes Assessment of foot pathology during walking should form an integral part of the clinical evaluation of children. Simple observation and video recording have limitations and are not quantifiable. Three-dimensional analysis of foot motion during walking can provide invaluable information on the dynamic function of the foot and can contribute to clinical decision making. As motion analysis technology advances, the accuracy and reliability of the dynamic assessment of the foot during walking will increase further, allowing clinicians to rely confidently on this information during patient assessment and the study of treatment outcomes. It is logical to expect that objective and quantifiable assessment of gait should be undertaken before and after treatment that sets gait improvement as one of i... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616774 Mon, 31 May 2010 23:00:00 +0100 3616774 http://www.medworm.com/index.php?rid=3616773&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000227%2Fabstract%3Frss%3Dyes A tarsal coalition is an aberrant union between 2 or more tarsal bones and can be classified as osseous (synostosis) or nonosseous (cartilaginous [synchondrosis] or fibrous [syndesmosis]). This union may be complete or partial and the joints in the hindfoot and midfoot are most commonly affected. The resulting abnormal articulation presents as a noncorrectable flat foot, usually during adolescence, leading to accelerated degeneration within adjacent joints. An understanding of the condition and presenting symptoms enable the clinician to correctly diagnose and initiate appropriate treatment. This review discusses the evidence-based literature on the cause, diagnosis, and current management of tarsal coalition. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616773 Mon, 31 May 2010 23:00:00 +0100 3616773 http://www.medworm.com/index.php?rid=3616772&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000239%2Fabstract%3Frss%3Dyes Accessory tarsal navicular is a common anomaly in the human foot. It should be in the differential of medial foot pain. A proper history and physical, along with imaging modalities, can lead to the diagnosis. Often, classification of the ossicle and amount of morbidity guide treatment. Nonsurgical measures can provide relief. A variety of surgical procedures have been used with good results. Our preferred method is excision for small ossicles and segmental fusion after removal of the synchondrosis for large ossicles. In addition, pes planovalgus deformities need to be addressed concomitantly. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616772 Mon, 31 May 2010 23:00:00 +0100 3616772 http://www.medworm.com/index.php?rid=3616771&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000124%2Fabstract%3Frss%3Dyes Pediatric and juvenile flatfoot is a common problem in childhood, present in one in nine children. The morphologic characteristics of this condition are heel valgus and flattening of the medial longitudinal arch. Other characteristics are usually observed, such as supination and abduction of the forefoot, tightening of the Achilles tendon, and hypertonia of the peroneal muscles. Most children with flatfoot will undergo spontaneous correction or become asymptomatic; those that are symptomatic require treatment. Subtalar arthroereisis, often combined with Achilles tendon lengthening, is a simple and effective way to treat flexible flatfoot in children. Mid- and long-term results are good, and the procedure does not prevent future treatments. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616771 Mon, 31 May 2010 23:00:00 +0100 3616771 http://www.medworm.com/index.php?rid=3616770&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000203%2Fabstract%3Frss%3Dyes Pes planus, commonly referred as flat foot, is a combination of foot and ankle deformities. When faced with this deformity in children, the treating surgeon should use a systematic method for evaluation to distinguish normal variation from true pathology, as well as conditions that have a benign natural history versus those that may lead to significant disability if left untreated. Certain deformities will inevitably worsen and therefore require surgery. Common sense clearly supports the indication for a simple procedure, such as an arthroereisis or an osteotomy, performed in the young child as opposed to an arthrodesis in older adolescence or adulthood as the foot becomes more rigid. Such approaches and other issues are discussed in this article. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616770 Mon, 31 May 2010 23:00:00 +0100 3616770 http://www.medworm.com/index.php?rid=3616769&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000136%2Fabstract%3Frss%3Dyes This article examines the evidence for the management of children who have idiopathic toe walking and reviews the literature on surgery for the lengthening of a calf contracture. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616769 Mon, 31 May 2010 23:00:00 +0100 3616769 http://www.medworm.com/index.php?rid=3616768&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000252%2Fabstract%3Frss%3Dyes There are limited studies about the incidence, nature, and severity of symptoms in adults with treated clubfoot; the rate at which symptoms increase and function diminishes with advancing age; and the appropriate treatments. One of the principles of treatment of these patients includes recognition that no one description of deformities applies to all cases of painful deformity in adults after childhood treatment of congenital clubfoot. There is a spectrum of the types of deformity and a range of severity among these that must be taken into account in the decision making regarding treatment. Although the level of symptoms is very variable and ankle and hindfoot arthrodeses have the disadvantage of increasing mechanical stress and subsequent arthritis in the midfoot, arthrodesis and, to a le... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616768 Mon, 31 May 2010 23:00:00 +0100 3616768 http://www.medworm.com/index.php?rid=3616767&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000240%2Fabstract%3Frss%3Dyes Most of the evidence to date on the Ilizarov method in the management of complex foot and ankle deformities in children is based on expert opinion and retrospective case series. Often the technique is used as a salvage option where conventional techniques are inappropriate or have failed. The decision to use the Ilizarov external fixator to an alternative technique depends on several issues: complexity of the pathology, patient compliance, surgeon skills, and the capacity of the institution to manage patients with multidisciplinary requirements. Nevertheless, the Ilizarov method has proved to be a valuable tool for the satisfactory management of many previously unresolved clinical problems. With greater experience and further developments, the exact place of this powerful treatment modalit... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616767 Mon, 31 May 2010 23:00:00 +0100 3616767 http://www.medworm.com/index.php?rid=3616766&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000148%2Fabstract%3Frss%3Dyes The deformities encountered in any patient who has residual clubfoot comprise various degrees of equinus, varus, adduction, supination, cavus, and toe deformity. Joint flexibility or stiffness, tarsal dysmorphism, articular incongruence, and progressive degrees of degeneration may be present. Add to this the scars of previous attempts at correction and various etiologic factors, and surgeons can find that treatment solutions are far from straightforward. A philosophy of careful history, examination, investigation, and surgery à la carte will provide a safe foundation for treating patients who have these often complex and difficult problems. A surgical strategy progressing from proximal to distal, performing soft tissue surgery before fixed deformity occurs, extra-articular osteotomies to ... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616766 Mon, 31 May 2010 23:00:00 +0100 3616766 http://www.medworm.com/index.php?rid=3616765&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000264%2Fabstract%3Frss%3Dyes Clubfoot is one of the most common congenital anomalies seen in newborns and children. Although the cause is unknown, strides have recently been made in uncovering the etiology causes of clubfoot. In the last decade, the treatment of clubfoot has undergone a significant change with a shift away from extensive operative intervention to a less invasive approach. Long-term residual deformity and pain from surgically corrected club feet still continues to occur and presents diagnostic and therapeutic challenges for the orthopedic surgeon. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616765 Mon, 31 May 2010 23:00:00 +0100 3616765 http://www.medworm.com/index.php?rid=3616764&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000343%2Fabstract%3Frss%3Dyes A wise man once said, “The child's foot is not just a smaller version of the adult foot.” (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616764 Mon, 31 May 2010 23:00:00 +0100 3616764 http://www.medworm.com/index.php?rid=3616763&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000410%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616763 Mon, 31 May 2010 23:00:00 +0100 3616763 http://www.medworm.com/index.php?rid=3616762&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000409%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616762 Mon, 31 May 2010 23:00:00 +0100 3616762 http://www.medworm.com/index.php?rid=3616761&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000392%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3616761 Mon, 31 May 2010 23:00:00 +0100 3616761 http://www.medworm.com/index.php?rid=3811029&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375151000029X%2Fabstract%3Frss%3Dyes Diabetes mellitus is a common disease in the world today and its prevalence is increasing. Foot and ankle complications, including infection, are the most common reason for hospital admission in patients with diabetes mellitus in the United States and are commonly encountered by the foot and ankle surgeon. Thorough clinical examination with appropriate use of adjunctive laboratory and imaging studies can allow for early diagnosis and treatment, which can improve patient outcomes. Mild infections can often be treated on an outpatient basis with oral antibiotics and local debridement, whereas more severe infections require hospitalization, intravenous antibiotics, and surgical debridement to fully eradicate the infection. Despite proper treatment, amputation is still common in diabetics. (So... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3811029 Sun, 09 May 2010 23:00:00 +0100 3811029 http://www.medworm.com/index.php?rid=3309526&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000094%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309526 Fri, 26 Feb 2010 15:09:53 +0100 3309526 http://www.medworm.com/index.php?rid=3309525&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001090%2Fabstract%3Frss%3Dyes This article discusses the common complications associated with lower extremity trauma and amputations secondary to combat injuries. The complications include retained fragments, soft tissue adhesions, poor wound healing, painful bursae, neuroma formation, heterotopic ossification, and depleted uranium. Although there is some literature on these topics, most is based on noncombat injuries, indicating a need for further research into the management of these devastating injuries. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309525 Fri, 26 Feb 2010 15:09:53 +0100 3309525 http://www.medworm.com/index.php?rid=3309524&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001065%2Fabstract%3Frss%3Dyes The Center for the Intrepid (CFI) is a unique facility among the three amputee care centers that comprise the Armed Forces Amputee Care Program. The mission of the CFI is threefold: (1) to provide the best possible patient care to the severely war-wounded, (2) to educate providers in the most advanced methods of rehabilitation for the severely wounded, and (3) to perform research to improve the care of these war-wounded patients. The center's program is based on three critical factors: (1) concentration of similarly injured patients as a cohort, (2) a multidisciplinary approach to patient care, and (3) the concentration of subspecialty skills that ensures the best possible care at an institutional level. The center's active training program benefits professional and ancillary personnel fro... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309524 Fri, 26 Feb 2010 15:09:53 +0100 3309524 http://www.medworm.com/index.php?rid=3309523&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001077%2Fabstract%3Frss%3Dyes This article highlights the challenges encountered and techniques used in the rehabilitation of soldiers with foot and ankle injuries sustained in recent combat operations. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309523 Fri, 26 Feb 2010 15:09:53 +0100 3309523 http://www.medworm.com/index.php?rid=3309522&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900103X%2Fabstract%3Frss%3Dyes This article discusses the surgical principles of lower extremity amputation and postoperative management of amputees, and the various prosthetic options available. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309522 Fri, 26 Feb 2010 15:09:53 +0100 3309522 http://www.medworm.com/index.php?rid=3309521&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001053%2Fabstract%3Frss%3Dyes Blast-related lower extremity trauma presents many challenges in its management that are not frequently experienced in high-energy civilian trauma. Because many of the blasts experienced in the current conflicts are ground based, the foot and ankle have sustained considerable severity and extent of injury because of the proximity of the blast. The high functional demands required of active service members create several reconstructive challenges. The authors' experience in the current conflicts has shown a similar trend, with the magnitude of soft tissue injury usually dictating whether or not salvage may be possible. Several reconstructive options for bone defect management are outlined and discussed. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309521 Fri, 26 Feb 2010 15:09:52 +0100 3309521 http://www.medworm.com/index.php?rid=3309520&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001089%2Fabstract%3Frss%3Dyes This article details the experiences of United States military reconstructive surgeons in the soft tissue management of war wounds of the foot and ankle resulting from the conflicts in Iraq and Afghanistan. War wounds from this conflict are commonly caused by blast and fragmentation, and are characteristically extensive, heterogeneous, and severe. Multiple serial débridement episodes are routinely necessary because of deterioration of the wounds over time, which is in contrast to civilian trauma wherein fewer débridement episodes are generally required. Wound therapy adjuncts, such as subatmospheric wound dressing and synthetic dermal replacement, have been used extensively with favorable results. Pedicled flaps, such as the distally based sural neurofasciocutaneous flap, are reliable, a... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309520 Fri, 26 Feb 2010 15:09:52 +0100 3309520 http://www.medworm.com/index.php?rid=3309519&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001041%2Fabstract%3Frss%3Dyes Combat injuries to the foot and ankle are challenging to treat due to frequent high-energy mechanisms, environmental contamination, and soft tissue and bony damage. Prevention and treatment of infections in injuries to the foot and ankle are critical to achieving the goals of tissue healing and restoration of function. The guidelines for treatment of these foot and ankle injuries are similar to those in place for civilians; however, allowances must be made for the realities of combat including an often austere environment, the need for evacuation, and limitations on resources available for treatment. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309519 Fri, 26 Feb 2010 15:09:52 +0100 3309519 http://www.medworm.com/index.php?rid=3309518&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001119%2Fabstract%3Frss%3Dyes The battlefield has provided a multitude of advancements in the management of hemorrhage and vascular repair. Basic understanding of the anatomy and exposures of lower extremity injuries is essential to any surgeon caring for these patients. The techniques of repair and potential adjunctive measures (eg, shunts) available should always be considered when approaching a vascular injury. The most important concept from a vascular standpoint is the fact that a multidisciplinary approach to these complex patients is required with maximal tissue preservation when feasible and safe. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309518 Fri, 26 Feb 2010 15:09:52 +0100 3309518 http://www.medworm.com/index.php?rid=3309517&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001144%2Fabstract%3Frss%3Dyes Determining whether to perform limb salvage or amputation in the traumatized lower extremity continues to be a difficult problem in the military and civilian sectors. Numerous predictive scores and models have failed to provide definitive criteria for prediction of limb-salvage success. Excellent support is available in the military health care system for soldiers electing to undergo either limb salvage or amputation. Recent experience with soldiers who sustained limb-threatening injuries has shown that delayed amputation after limb-salvage attempts is a viable option for soldiers wounded in combat. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309517 Fri, 26 Feb 2010 15:09:52 +0100 3309517 http://www.medworm.com/index.php?rid=3309516&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001120%2Fabstract%3Frss%3Dyes Prophylactic and therapeutic treatment of leg compartment syndrome with decompression by double-incision fasciotomy prevents progression of soft-tissue injury in high-energy trauma. This treatment is the standard of care in civilian trauma and combat settings. More controversial is the use of either single- or dual-incision fasciotomy of the foot for prophylactic treatment of foot compartment syndrome. Fasciotomy must be performed in the face of major trauma to the foot with severe swelling and unremitting pain. The role for prophylactic fasciotomy of the foot is unclear and should be considered on a case by case basis. The surgeon must maintain a high degree of vigilance for the development of compartment syndrome in the combat casualty. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309516 Fri, 26 Feb 2010 15:09:52 +0100 3309516 http://www.medworm.com/index.php?rid=3309515&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001107%2Fabstract%3Frss%3Dyes Tourniquets have been called powerful lifesaving devices by some authors, whereas others say they cause more harm than good. Given recent emergency tourniquet developments in scientific design of devices, widespread user training, modern doctrine based on evidence, and thorough fielding to users within an integrated trauma system with rapid evacuation, tourniquets have shown minor morbidity and major lifesaving results. Trauma systems with poorly designed devices, inadequate user training, no tourniquet doctrine, or slow casualty evacuation, however, have repeatedly shown severe morbidity and mortality. Tourniquets may save lives if the right device is used in the right way at the right time for the right patient. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309515 Fri, 26 Feb 2010 15:09:52 +0100 3309515 http://www.medworm.com/index.php?rid=3309514&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001132%2Fabstract%3Frss%3Dyes Foot and ankle trauma sustained in the Global War on Terror have unique causes and characteristics. At least one-quarter of all battle injuries involve the lower extremity. These severe lower extremity wounds require specialized early treatment. Ballistic mechanisms cause almost all injuries, and as such, most combat foot and ankle wounds are open in nature. Wounds are characteristically caused by blast mechanisms, but high velocity gunshot injuries are also common. The severe and polytraumatic nature of injuries sustained frequently call for damage control orthopaedics to be utilized. Cautious early treatment of irregular and highly exudative ballistic wounds with subatmospheric wound dressings may ease their early management. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309514 Fri, 26 Feb 2010 15:09:52 +0100 3309514 http://www.medworm.com/index.php?rid=3309513&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001156%2Fabstract%3Frss%3Dyes Putting together this issue was very easy on one level and very difficult on another. We have both worked with many great military orthopedic surgeons, so finding experts on the topics we chose to cover was simple. The difficult part came in realizing that we could invite contributions from only some of these experts. There are many, many orthopedic surgeons from all branches of the Armed Forces and, indeed, internationally whom we were not able to include despite their monumental contributions in time and thought to advance military orthopedic traumatology in this time of war. We would like to thank them all for their expertise in caring for the wounded warriors and for teaching us how to better our care of patients. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309513 Fri, 26 Feb 2010 15:09:52 +0100 3309513 http://www.medworm.com/index.php?rid=3309512&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000082%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309512 Fri, 26 Feb 2010 15:09:52 +0100 3309512 http://www.medworm.com/index.php?rid=3309511&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000070%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309511 Fri, 26 Feb 2010 15:09:52 +0100 3309511 http://www.medworm.com/index.php?rid=3309510&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751510000069%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=3309510 Fri, 26 Feb 2010 15:09:52 +0100 3309510 http://www.medworm.com/index.php?rid=2926047&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000904%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926047 Mon, 26 Oct 2009 15:22:07 +0100 2926047 http://www.medworm.com/index.php?rid=2926046&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000795%2Fabstract%3Frss%3Dyes The operative management of acute Achilles tendon rupture marks the beginning of a comprehensive rehabilitation program. The goals of the rehabilitation program start with the reduction of pain and swelling and the recovery of ankle motion and power. They conclude with the restoration of coordinated activity and safe return to athletic activity. The rehabilitation protocol is directed by the injury and the quality of the repair, along with the patient's age, medical and social history, and athletic inclination. The protocol is dynamic and responsive to changing clinical findings. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926046 Mon, 26 Oct 2009 15:22:07 +0100 2926046 http://www.medworm.com/index.php?rid=2926045&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000771%2Fabstract%3Frss%3Dyes This article focuses on these calf injuries, including injuries of the gastrocnemius, plantaris, soleus, and flexor hallucis longus, which may occasionally be mistaken for Achilles tendon disorders. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926045 Mon, 26 Oct 2009 15:22:07 +0100 2926045 http://www.medworm.com/index.php?rid=2926044&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000783%2Fabstract%3Frss%3Dyes This article delineates the incidence for each of these complications, with differing techniques, methods of avoiding these complications and treatment methods if they occur. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926044 Mon, 26 Oct 2009 15:22:07 +0100 2926044