Operative Techniques: Foot and Ankle Surgery

Proximal Tibia Bone Graft

Indications Fusions and complex fractures in the foot and ankle often require cancellous bone graft. Ample bone (≤30 cc) is available from the proximal tibia. Bone harvest from the proximal tibial is less painful then from the iliac crest. The…

Calf (Gastrocnemius) Release for Equinus Contracture

Acknowledgments Andrew K. Sands would like to acknowledge the assistance of Edmund Choi, MD, with this chapter. Indications Equinus contracture/tight calf is typically an associated condition of a primary diagnosis of a bunion and may exacerbate the bunion problem. In…

Posterior Tibial Tendon Transfer for Footdrop

Indications Flaccid footdrop following traumatic injury to the common peroneal nerve or peroneal division of the sciatic nerve Spastic footdrop seen in cerebral palsy Other indications may include footdrop associated with poliomyelitis, cerebrovascular accident, Charcot-Marie-Tooth disease, or leprosy Indications Pitfalls…

Malunion of Fibula Fractures

Technique #1: Distal Fibular Osteotomy Through Fracture Site Indications This should be utilized for a fracture below the level of the syndesmosis, usually with a stable syndesmosis that can be preserved Fibular shortening Fibular malrotation Syndesmosis malreduction Indications Pitfalls Fibular…

Arthroscopic Fracture Reduction With Fibular Nail

Indications Patients with potential wound healing issues such as diabetes, soft tissue trauma, or older age Weber C fractures in younger patients to avoid extensive dissection Patients with medial and posterior malleolar fractures that are amenable to percutaneous reduction and…

Calcaneoplasty for Insertional Tendinopathy of Achilles Tendon

Indications Haglund Syndrome refractory to conservative measures Bony prominence Posterior-superior-lateral Retrocalcaneal bursitis Insertional Achilles tendinopathy Partial rupture Often associated with bony prominence Recurrent tendinopathy after failed surgery Indications Pitfalls Local infection Peripheral vascular disease Indications Controversies Severe pes cavovarus with…

Ligament Reconstruction for Chronic Medial Ankle Instability

Indications Chronic medial ankle instability based on patient’s feeling of “giving-way,” especially toward medial, when walking on even ground, downhill, or downstairs Pain at the anteromedial aspect of the ankle, and sometimes pain in the lateral ankle, especially during dorsiflexion…

Chronic Peroneal Tendon Subluxation-Dislocation

Indications Symptomatic chronic peroneal tendon subluxation-dislocation Indications Pitfalls Check for concomitant varus hindfoot alignment and lateral ankle instability that needs to be addressed during surgery. Treatment Options Nonsurgical treatment is an option for acute dislocation of the peroneal tendons, but…