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, 18 Mar 2010 15:06:47 +0100 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 http://www.medworm.com/index.php?rid=2926043&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000850%2Fabstract%3Frss%3Dyes This article discusses the general principles of tendon transfers with regard to Achilles tendon function, the surgical techniques involved, and published results using these techniques. The goal is to provide the orthopedic foot and ankle surgeon with a wide variety of techniques to solve both the straightforward Achilles tendon problem as well as the difficult revision case. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926043 Mon, 26 Oct 2009 15:22:07 +0100 2926043 http://www.medworm.com/index.php?rid=2926042&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000813%2Fabstract%3Frss%3Dyes This article reviews some of the methods that have been described to treat the chronic or neglected Achilles tendon rupture. The methods that have been used include gastrocnemius advancement, fascial turndown flaps, local tendon transfers, free tissue transfer, and use of synthetic grafts. There are no comparative data to guide evidence-based decision making in regard to choosing between treatment options. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926042 Mon, 26 Oct 2009 15:22:06 +0100 2926042 http://www.medworm.com/index.php?rid=2926041&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000758%2Fabstract%3Frss%3Dyes This article focuses on open repair of acute Achilles tendon rupture. Surgical techniques, rehabilitation protocol, and the authors' preferred method are described. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926041 Mon, 26 Oct 2009 15:22:06 +0100 2926041 http://www.medworm.com/index.php?rid=2926040&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900076X%2Fabstract%3Frss%3Dyes This article reviews minimal incision techniques in the treatment of acutely ruptured Achilles tendon and the results that can be anticipated from these methods. However, lack of robust prospective randomized studies on the treatment of Achilles tendon rupture makes it impossible to draw conclusions on optimal treatment strategies. The bulk of the evidence available suggests that surgical repair reduces rerupture rates compared with non-operatively treated tendon ruptures. Surgery does have potential complications, but as outlined in the article, using a mini-open or percutaneous technique of repair might result in highly satisfactory outcomes with acceptably low complication rates. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926040 Mon, 26 Oct 2009 15:22:06 +0100 2926040 http://www.medworm.com/index.php?rid=2926039&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000825%2Fabstract%3Frss%3Dyes This article highlights the current controversy and outlines the rationale for nonsurgical treatment of acute Achilles tendon ruptures. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926039 Mon, 26 Oct 2009 15:22:06 +0100 2926039 http://www.medworm.com/index.php?rid=2926038&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000746%2Fabstract%3Frss%3Dyes This article provides a review of many of the emerging techniques in the treatment of Achilles tendinopathy. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926038 Mon, 26 Oct 2009 15:22:06 +0100 2926038 http://www.medworm.com/index.php?rid=2926037&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000874%2Fabstract%3Frss%3Dyes Noninsertional Achilles tendinitis is a distinct clinical entity, frequently characterized by swelling, pain, and lower limb dysfunction. This condition can be frustrating to treat, for the patient and the physician alike, as reflected in the various treatments, both conservative and surgical, that have been described. Although many patients with Achilles tendinitis can be successfully treated with nonoperative methods, persistent symptoms require surgical treatment, such as tenotomy, debridement, or repair. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926037 Mon, 26 Oct 2009 15:22:06 +0100 2926037 http://www.medworm.com/index.php?rid=2926036&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000837%2Fabstract%3Frss%3Dyes Insertional Achilles tendinopathy can be a painful debilitating condition that should initially be treated non-operatively. If pain becomes chronic and debilitating, despite appropriate conservative treatment, debridement of the diseased portion of the Achilles tendon and removal of the impinging calcaneal prominence and transfer of the flexor hallucis longus through a single incision can be a reliable pain relieving procedure with relatively high patient satisfaction. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926036 Mon, 26 Oct 2009 15:22:06 +0100 2926036 http://www.medworm.com/index.php?rid=2926035&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000801%2Fabstract%3Frss%3Dyes This article reviews the anatomical and evolutionary basis for human foot structure, implications of tight gastrocnemius, and specific disease states. Operative releases for lengthening, including proximal gastrocnemius recession, tendo-Achilles lengthening, and endoscopic recession, are detailed. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926035 Mon, 26 Oct 2009 15:22:06 +0100 2926035 http://www.medworm.com/index.php?rid=2926034&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000849%2Fabstract%3Frss%3Dyes The complexity of its anatomy coupled with the biomechanics of the Achilles tendon may explain the frequency of injury to this structure. Its unique characteristic of the muscle crossing three joints (knee, ankle, and subtalar joints) makes it more susceptible to injury than muscles that span a single joint. A better understanding of the contributing pathologic conditions associated with functional shortening of the gastroc-soleus complex and its effects on the normal biomechanics of the foot and ankle may improve the treatment of the many and varied pathologies that occur within the tendon itself and the associated abnormalities that occur with a tight Achilles tendon. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926034 Mon, 26 Oct 2009 15:22:06 +0100 2926034 http://www.medworm.com/index.php?rid=2926033&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000898%2Fabstract%3Frss%3Dyes Despite the frequency with which they occur and the many articles written about them, disorders of the Achilles tendon continue to be the subject of controversy. Even the terminology to describe conditions affecting the Achilles tendon is controversial; tendinopathy, tendinosis, tendinitis, tenosynovitis, peritendinitis, and achillodynia, among others, have all been used. The etiology, pathogenesis, and natural history of Achilles disorders remain largely unknown, and there are no definitive criteria to differentiate acute from chronic conditions. Although most acute Achilles tendon injuries occur in athletes involved in sports that require repetitive impact loading, such as jumping or running, approximately 25% of patients with Achilles tendon injuries have no history of athletic involvem... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926033 Mon, 26 Oct 2009 15:22:05 +0100 2926033 http://www.medworm.com/index.php?rid=2926032&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000886%2Fabstract%3Frss%3Dyes I am certain that the readers are all familiar with the eponymic origin of Achilles to describe the tendon we are so accustomed to treating. There are certainly eponymic uses of injuries, procedures, techniques, and tests, but there are no other anatomic parts of the lower limb that have such significance. Perhaps this is wrapped up in the mythology of the same, or the significance that we attach to this tendon (no pun intended). There are certain treatments of Achilles tendon pathology that I have not changed much in 25 years. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926032 Mon, 26 Oct 2009 15:22:05 +0100 2926032 http://www.medworm.com/index.php?rid=2926031&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001016%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926031 Mon, 26 Oct 2009 15:22:05 +0100 2926031 http://www.medworm.com/index.php?rid=2926030&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509001004%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2926030 Mon, 26 Oct 2009 15:22:05 +0100 2926030 http://www.medworm.com/index.php?rid=2739779&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000709%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739779 Fri, 28 Aug 2009 12:30:53 +0100 2739779 http://www.medworm.com/index.php?rid=2739778&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000254%2Fabstract%3Frss%3Dyes This article provides an overview of the principles and results of the use of external fixation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739778 Fri, 28 Aug 2009 12:30:53 +0100 2739778 http://www.medworm.com/index.php?rid=2739777&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900059X%2Fabstract%3Frss%3Dyes The supramalleolar osteotomy is a commonly used surgical procedure to correct congenital or acquired deformities of the distal tibia, ankle, or foot. In children, osteotomy has been used to correct malunion of fractures, physeal growth arrest, tibial torsion, paralytic deformities, and sequelae of a clubfoot. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739777 Fri, 28 Aug 2009 12:30:53 +0100 2739777 http://www.medworm.com/index.php?rid=2739776&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000333%2Fabstract%3Frss%3Dyes The goal of ankle and hindfoot reconstruction should be to address the presenting concerns of the patient and the deformity and to achieve a stable, functional, and plantigrade foot. These goals are accomplished by using appropriate preoperative patient assessment and planning and using meticulous intraoperative technique and aftercare. An algorithmic approach to multiplanar hindfoot deformity is presented in this article along with the author's preferred method of treatment, aftercare, and management of complications. Great emphasis is given to preoperative planning in order to ensure the best possible postoperative outcomes. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739776 Fri, 28 Aug 2009 12:30:53 +0100 2739776 http://www.medworm.com/index.php?rid=2739775&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000588%2Fabstract%3Frss%3Dyes Reconstruction surgery of the midand hindfoot is a demanding challenge for foot surgeons. Satisfactory results depend not only on surgical technique and skills but also on the knowledge of underlying disorders, pathomechanics, and indication criteria. The cavovarus foot, the planovalgus foot, and Charcot's foot are some of the most challenging foot deformities, requiring different surgical strategies for their correction. Most of the osteotomies and fusions in children and adults can be fixed with transcutaneous Kirschner wires, which are inexpensive and easy to use and remove. The use of alternative fixation systems such as cannulated screws, compression screws, or angle-stable locking plates depends on patient age, vascular situation, risk for nonunion, and underlying pathology. (Source:... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739775 Fri, 28 Aug 2009 12:30:53 +0100 2739775 http://www.medworm.com/index.php?rid=2739774&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000242%2Fabstract%3Frss%3Dyes This article presents a surgical protocol for surgical reconstruction from the subtle cavus foot described by Manoli to the most complicated cases. The goal is to merge together the available surgical options in a comprehensive way to guide surgical decisions. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739774 Fri, 28 Aug 2009 12:30:53 +0100 2739774 http://www.medworm.com/index.php?rid=2739773&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000321%2Fabstract%3Frss%3Dyes This article focuses on the treatment of multiplanar neuromuscular foot deformities with external fixation, reviewing the indications, preoperative planning, techniques, and complications. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739773 Fri, 28 Aug 2009 12:30:53 +0100 2739773 http://www.medworm.com/index.php?rid=2739772&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000278%2Fabstract%3Frss%3Dyes A simplified standard setting of the circular external fixator allows correction of all the complex deformities of recurrent clubfoot with minimal surgical intervention and no major complications. In those cases where additional corrective arthrodesis is necessary, it is performed with minimal bone resection because the severe deformities of the foot and ankle have already been corrected. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739772 Fri, 28 Aug 2009 12:30:53 +0100 2739772 http://www.medworm.com/index.php?rid=2739771&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000606%2Fabstract%3Frss%3Dyes is a rare deformity characterized by forefoot adduction and hindfoot valgus. Its etiology and natural history are unknown, although congenital and syndromic forms are observed. Currently, there is no consent about the treatment of skewfoot. Due to its potential resistance to the effects of therapy, it must be differentiated from other, more common deformities. Treatment involves conservative and, most often, operative measures. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739771 Fri, 28 Aug 2009 12:30:53 +0100 2739771 http://www.medworm.com/index.php?rid=2739770&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900031X%2Fabstract%3Frss%3Dyes This article reviews three techniques designed to achieve lasting deformity correction and successful arthrodesis: plantar plating, locked plating, and axial screw fixation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739770 Fri, 28 Aug 2009 12:30:52 +0100 2739770 http://www.medworm.com/index.php?rid=2739769&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000618%2Fabstract%3Frss%3Dyes This article reviews the reconstructive strategies for correction of deformity and fusion of the painful arthritic joints. A stepwise surgical approach is recommended for reproducible correction and midfoot fusion in patients with arthritis combined with a multiplanar deformity. The article focuses on the principles of reconstruction of the planovalgus deformity in the non-neuropathic patient using compression plates for a stable construct fixation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739769 Fri, 28 Aug 2009 12:30:52 +0100 2739769 http://www.medworm.com/index.php?rid=2739768&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000230%2Fabstract%3Frss%3Dyes The treatment of the congruent hallux valgus deformity requires special consideration for a successful outcome to be obtained. The distal metatarsal articular angle is of critical importance in this deformity. The goal of correction is to achieve a realigned first ray and preserve the congruent first metatarsophalangeal articulation. In patients with an increased distal metatarsal articular angle and congruent joint, the use of double and triple first ray osteotomies must be used to achieve satisfactory correction. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739768 Fri, 28 Aug 2009 12:30:52 +0100 2739768 http://www.medworm.com/index.php?rid=2739767&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900062X%2Fabstract%3Frss%3Dyes Deformity correction is a complex and rewarding surgical challenge. Multiplanar deformities are particularly difficult, requiring an in-depth understanding not only of the radiographic abnormalities but also of the underlying pathogenesis. Surgical correction must address each component in the ankle, hindfoot, midfoot, and forefoot to create a functional limb. The presence of multiple sites of deformity requires thorough preoperative planning and a systematic approach to be successful. The contribution of muscular imbalance, ligamentous instability, bony abnormality, presence of degenerative changes, and prior surgery must be taken into account. The method of fixation must be considered, as this may determine the type of osteotomy that is required. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739767 Fri, 28 Aug 2009 12:30:52 +0100 2739767 http://www.medworm.com/index.php?rid=2739766&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000692%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739766 Fri, 28 Aug 2009 12:30:52 +0100 2739766 http://www.medworm.com/index.php?rid=2739765&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000680%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2739765 Fri, 28 Aug 2009 12:30:49 +0100 2739765 http://www.medworm.com/index.php?rid=2466315&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000539%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466315 Mon, 01 Jun 2009 04:00:00 +0100 2466315 http://www.medworm.com/index.php?rid=2466314&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000199%2Fabstract%3Frss%3Dyes This article discusses diagnostic and technical points in relation to advanced uses of the arthroscope. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466314 Mon, 01 Jun 2009 04:00:00 +0100 2466314 http://www.medworm.com/index.php?rid=2466313&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000163%2Fabstract%3Frss%3Dyes This article discusses the mechanism of injury, methods of patient evaluation and management, complications, and outcomes. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466313 Mon, 01 Jun 2009 04:00:00 +0100 2466313 http://www.medworm.com/index.php?rid=2466312&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000217%2Fabstract%3Frss%3Dyes Athletes with unstable ankle injuries treated with rigid and anatomic internal fixation with concomitant repair of indicated ligaments followed by an accelerated rehabilitation program consisting of early weight bearing and near-immediate range of motion (ROM) can obtain excellent outcomes. Early ROM and weight bearing, if indicated depending on the specific injury pattern, can be effective with low morbidity. Return to sports can be expected as early as 4 weeks after rigid fixation of an isolated fibula fracture and up to 8 to 10 weeks after stabilization of a bimalleolar equivalent fracture with deltoid repair. Syndesmosis fixation can take up to 4 to 6 months before successful return to sport. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466312 Mon, 01 Jun 2009 04:00:00 +0100 2466312 http://www.medworm.com/index.php?rid=2466311&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000308%2Fabstract%3Frss%3Dyes This article reviews the clinical spectrum of disease and presents contemporary treatment options. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466311 Mon, 01 Jun 2009 04:00:00 +0100 2466311 http://www.medworm.com/index.php?rid=2466310&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000175%2Fabstract%3Frss%3Dyes Plantar fasciitis is a common problem without known etiology. It responds well to multiple conservative modalities and no particular modality has been demonstrated to be clearly superior in the treatment of this condition. Over 90% of patients will be cured by non-operative treatment but this may require 6 to 12 months of treatment and encouragement by the physician. Extracorporeal shock wave therapy is a noninvasive treatment with a success rate comparable to surgery and a low complication rate. Surgery can be done endoscopically or open with similar long-term outcomes. Patients appear to recover from endoscopic treatment 4 to 5 weeks earlier than the open group. If there is a suggestion of FBLPN entrapment, then patients should have an open release. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466310 Mon, 01 Jun 2009 04:00:00 +0100 2466310 http://www.medworm.com/index.php?rid=2466309&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000229%2Fabstract%3Frss%3Dyes This article discusses osteochondral lesions of the talus, treatment options, and resurfacing techniques. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466309 Mon, 01 Jun 2009 04:00:00 +0100 2466309 http://www.medworm.com/index.php?rid=2466308&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900014X%2Fabstract%3Frss%3Dyes Ankle instability in the athlete is a common problem that is routinely treated non-operatively, with a 90% success rate. With proprioceptive training, preventive equipment (bracing/taping), and closed kinetic chain strengthening, surgery for ankle instability is uncommon. Nonetheless, some athletes present with recurrent ankle instability that, despite work-up and conservative treatment, requires surgical correction. The use of a primary ligament repair (Brostrom procedure) versus augmented (anatomic) reconstructions is discussed in detail in this article. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466308 Mon, 01 Jun 2009 04:00:00 +0100 2466308 http://www.medworm.com/index.php?rid=2466307&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000151%2Fabstract%3Frss%3Dyes Despite increased awareness of stress fractures of the tarsal navicular and a heightened index of suspicion by those physicians evaluating sports related foot pain, these injuries remain difficult to diagnose. There is often a considerable delay in the diagnosis because of its subtle and often vague clinical presentation. Accompanying a thorough history and physical, the authors recommend plain radiographs of the foot and ankle, followed by a CT scan to fully characterize any fracture of the navicular and to rule out other etiologies of foot pain. If a CT scan is negative, and a high clinical suspicion persists, an MRI scan is then obtained to rule out a stress reaction. While often successful, non-operative treatment of navicular stress fractures is prolonged and often frustrating to the ... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466307 Mon, 01 Jun 2009 04:00:00 +0100 2466307 http://www.medworm.com/index.php?rid=2466306&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000266%2Fabstract%3Frss%3Dyes This article discusses issues related to anatomy, clinical presentation, mechanism of injury, and diagnosis that are necessary to provide appropriate treatment for these injuries. There should be a high index of suspicion of this injury, and prompt diagnosis is important to allow athletes to return to sport with the best possible outcome. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466306 Mon, 01 Jun 2009 04:00:00 +0100 2466306 http://www.medworm.com/index.php?rid=2466305&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS108375150900028X%2Fabstract%3Frss%3Dyes Using radiographs culled over a 33-month period, the treatment, complications, revision, and rehabilitation of complicated Jones fractures and stress fractures involving the proximal diaphysis are examined. Although the non-operative approach remains viable, the exigencies and desires of the athletic and leg-based working population require sooner-rather-than-later return to play or work. Fortunately, these needs can be matched by the available and functioning orthopedic practice of intramedullary screw fixation. This practice is coupled with prevention, reliable orthopedic techniques, the orthopedist's surgical skills, and devices necessary for successful surgery. Recent attention directed toward handling complications promise better, quicker, and more reliable recovery for the patient. (... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466305 Mon, 01 Jun 2009 04:00:00 +0100 2466305 http://www.medworm.com/index.php?rid=2466304&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000138%2Fabstract%3Frss%3Dyes Turf toe injuries and sesamoid injuries are challenging because of the variety of causes that exist as sources of pain. Through a systematic approach to evaluation, injuries to the hallux metatarsophalangeal joint can be diagnosed properly. Correct diagnosis leads to accurate and efficient treatment. If conservative measures fail, operative interventions are available to relieve pain and restore function. With careful surgical technique and appropriate postoperative management, athletes can return to play and efficiently reach their pre-injury level of participation. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466304 Mon, 01 Jun 2009 04:00:00 +0100 2466304 http://www.medworm.com/index.php?rid=2466303&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000291%2Fabstract%3Frss%3Dyes Discussions of these issues, and more, are in this issue highlighting complicated foot and ankle problems in the athlete. Enjoy and be up to date! (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466303 Mon, 01 Jun 2009 04:00:00 +0100 2466303 http://www.medworm.com/index.php?rid=2466302&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000205%2Fabstract%3Frss%3Dyes What are your goals for treatment of the athlete? Who is an athlete? Today, more and more patients consider themselves athletically active, and indeed some of the articles in this issue address these specific individuals who suffer from activity- and stress-related injuries. Many other patients, however, have variants of these problems (ie, tendinosis, bone impingement, arthritis) which are not in any way caused, but aggravated and made more symptomatic by the sporting activity. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466302 Mon, 01 Jun 2009 04:00:00 +0100 2466302 http://www.medworm.com/index.php?rid=2466301&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000527%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466301 Mon, 01 Jun 2009 04:00:00 +0100 2466301 http://www.medworm.com/index.php?rid=2466300&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000515%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2466300 Mon, 01 Jun 2009 04:00:00 +0100 2466300 http://www.medworm.com/index.php?rid=2351670&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000096%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351670 Sun, 01 Mar 2009 05:00:00 +0100 2351670 http://www.medworm.com/index.php?rid=2351669&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000946%2Fabstract%3Frss%3Dyes Arthroscopy of the first MTP joint is a useful, minimally invasive technique in treating a number of pathologies about the hallux MTP joint. However, it is a technically demanding procedure for which there is a learning curve. The small arthroscope and instrumentation are delicate and vulnerable to damage. Practice on cadavers is very useful in shortening this learning curve, and experience with arthroscopy in other joints facilitates the transition to the hallux. In the future, additional studies will help to more specifically define the indications and expected outcomes of treatment as such will help to further elucidate the potential benefits over open surgery. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351669 Sun, 01 Mar 2009 05:00:00 +0100 2351669 http://www.medworm.com/index.php?rid=2351668&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000934%2Fabstract%3Frss%3Dyes This article outlines the diagnosis and treatment of these entities and reviews the results of these treatments. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351668 Sun, 01 Mar 2009 05:00:00 +0100 2351668 http://www.medworm.com/index.php?rid=2351667&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000971%2Fabstract%3Frss%3Dyes Malunion of a first metatarsal osteotomy or fracture can result in dorsal angulation of the distal fragment and shortening of the metatarsal, among other deformities. Dorsal malunion can be caused by improper orientation of the osteotomy, poor intraoperative fixation, or loss of fixation post-operatively due to premature weight bearing or catastrophic failure. There is little in the literature on the rate and incidence of malunion following first metatarsal fractures treated either operatively or nonoperatively. However, treatment options would be similar as for malunion following an osteotomy. The treatment of malunions depends on how symptomatic the patient is, including pain, difficulty with ambulation, and whether they complain of transfer metatarsalgia. (Source: Foot and Ankle Clinics... Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351667 Sun, 01 Mar 2009 05:00:00 +0100 2351667 http://www.medworm.com/index.php?rid=2351666&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508001010%2Fabstract%3Frss%3Dyes Nerve disorders about the hallux can generate remarkable pain and dysfunction. Whether caused by soft tissue entrapment, trauma, iatrogenic injury, or from an idiopathic basis; nerve disorders are approached by careful history and examination followed by nonoperative treatment. In cases that do not respond, meticulous surgical management can be helpful in many cases. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351666 Sun, 01 Mar 2009 05:00:00 +0100 2351666 http://www.medworm.com/index.php?rid=2351665&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000983%2Fabstract%3Frss%3Dyes This article focuses on iatrogenic hallux varus following bunion surgery, but the same principles apply to other causes of acquired hallux varus. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351665 Sun, 01 Mar 2009 05:00:00 +0100 2351665 http://www.medworm.com/index.php?rid=2351664&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000995%2Fabstract%3Frss%3Dyes Arthrodesis of the first metatarsophalangeal joint is a highly successful treatment for patients with symptomatic hallux rigidus who have failed conservative management. Before arthrodesis, the importance of host factors, such as use of nicotine, local blood supply, medical comorbidites, and use of systemic immunosuppressive agents, must be considered. Arthrodesis is currently considered the gold standard treatment for end-stage arthritis of the metatarsophalangeal joint. Careful attention to surgical detail is critical to achieving optimal outcomes. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351664 Sun, 01 Mar 2009 05:00:00 +0100 2351664 http://www.medworm.com/index.php?rid=2351663&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508001009%2Fabstract%3Frss%3Dyes This article discusses various implant options along with clinical outcomes and complications. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351663 Sun, 01 Mar 2009 05:00:00 +0100 2351663 http://www.medworm.com/index.php?rid=2351662&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000958%2Fabstract%3Frss%3Dyes The treatment of advanced hallux rigidus in an older, more sedentary population with poor bone stock or comorbidities that may make corrective osteotomy, fusion, and implant fixation more problematic has frequently been an issue for orthopedic surgeons. The traditional Keller resection arthroplasty has not fared well because of various problems. Crescentic oblique basilar resection arthroplasty is a viable surgical treatment alternative for older, more sedentary patients who have advanced hallux rigidus with or without hallux valgus. This may also be a good alternative procedure in a more active patient who wishes to avoid fusion of the joint while maintaining some first MTP motion. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351662 Sun, 01 Mar 2009 05:00:00 +0100 2351662 http://www.medworm.com/index.php?rid=2351661&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000922%2Fabstract%3Frss%3Dyes Cheilectomy has long been the standard treatment in the orthopedic community for mild to moderate cases of hallux rigidus, with established long-term excellent results. Osteotomies of the proximal phalanx and first metatarsal have been described mainly in the podiatric literature; they have shown good outcomes in small patient groups with short-term follow-up. Proper patient selection is critical to obtaining favorable outcomes with any of the joint-sparing procedures. Patients with severe arthritic changes and pain in the midrange arc of motion have poorer outcomes with these procedures and are better served with joint-destructive procedures, such as arthroplasty or arthrodesis. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351661 Sun, 01 Mar 2009 05:00:00 +0100 2351661 http://www.medworm.com/index.php?rid=2351660&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508000910%2Fabstract%3Frss%3Dyes Hallux rigidus is a degenerative osteoarthritic process characterized by progressive loss of metatarsophalangeal joint range of motion and notable dorsal or periarticular osteophyte formation. Documented factors associated with hallux rigidus are a flat or chevron-shaped joint, hallux valgus interphalangeus, metatarsus adductus, bilaterality in persons with a positive family history, trauma history in unilateral cases, and female gender. Elevation of the first ray noted radiographically is thought to be a sign of worsening metatarsophalangeal joint function. Nonoperative care is aimed at improving comfort of the toe and foot with roomy shoes, selective joint injections, taping, and selective use of orthotics. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351660 Sun, 01 Mar 2009 05:00:00 +0100 2351660 http://www.medworm.com/index.php?rid=2351659&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508001022%2Fabstract%3Frss%3Dyes The hallux and first ray play a crucial role in stance, ambulation, and propulsion. During stance phase, normal gait demonstrates progression of pressure through the foot, terminating in the hallux. Disorders of the hallux and first metatarsal can impair this function, resulting in dramatic effects on gait. Hallux valgus has commanded significant attention as a disorder that alters forefoot mechanics and disrupts patients' function. Other conditions of the hallux and first ray may draw less attention, but can similarly cause severe pain and impairment. This issue of Foot and Ankle Clinics will focus on these other topics, some of which are common and others which are esoteric but no less important. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351659 Sun, 01 Mar 2009 05:00:00 +0100 2351659 http://www.medworm.com/index.php?rid=2351658&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751508001034%2Fabstract%3Frss%3Dyes Surgical correction of hallux rigidus is fairly predictable, and patient acceptance and outcome should be good. There are many surgical alternatives to choose from, all based on the underlying anatomy, the pathology, and the extent of arthritis. To some extent, patient needs for activities and shoe wear do play a role, but in general, this should not influence the decision making for the type of surgery. (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351658 Sun, 01 Mar 2009 05:00:00 +0100 2351658 http://www.medworm.com/index.php?rid=2351657&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000084%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351657 Sun, 01 Mar 2009 05:00:00 +0100 2351657 http://www.medworm.com/index.php?rid=2351656&cid=s_38473_31_f&fid=38473&url=http%3A%2F%2Fwww.foot.theclinics.com%2Farticle%2FPIIS1083751509000072%2Fabstract%3Frss%3Dyes (Source: Foot and Ankle Clinics) Foot and Ankle Clinics journals http://www.medworm.com/rss/comments.php?id=2351656 Sun, 01 Mar 2009 05:00:00 +0100 2351656