Indications Displaced intraarticular calcaneus fractures Simpler patterns Early fixation Patients at high risk for wound healing complications with extensile approaches including smokers, diabetics, and those with medical comorbidities Indications Pitfalls Inexperience with calcaneus fracture reduction techniques Fractures treated beyond 2–3…
Indications Nonoperative management is indicated for nondisplaced calcaneal fractures or extraarticular calcaneal fractures with near-physiologic hindfoot alignment (computed tomography [CT] confirmation is recommended). Operative treatment of calcaneus fractures is indicated for displaced intraarticular and open calcaneal fractures. Indications Pitfalls When…
Indications Intraarticular calcaneal fractures with ≥2 mm step off of the posterior facet, and intraarticular calcaneal fractures with Böhler angle <15° on lateral radiographs of the foot or ankle Contraindications: vascular insufficiency, poorly controlled diabetes, smokers, and noncompliant patients Relative…
Indications Rigid varus hindfoot deformity Indications Pitfalls If an underlying neurologic disease is suspected, a neurologic assessment should be considered before surgery is performed. Indications Controversies Consider a dorsiflexion osteotomy of the metatarsal if the hindfoot varus is due to…
Pitfalls Charcot-Marie-Tooth (CMT) disease includes a wide spectrum of hereditary motor and sensory neuropathies. These diseases are often progressive, which can compromise the long-term results of a surgical reconstruction. The feet of older adolescents and adults usually require simultaneous osteotomies,…
Indications Posterior tibial tendon insufficiency (PTTI), stage II to stage II–III Medial ankle instability Both must be accompanied by supple pes planovalgus et abductus deformity with forefoot supination and subfibular impingement, and preserved subtalar and talonavicular joints Indications Pitfalls Calcaneal…
Indications Alternative to double osteotomy in acquired flatfoot deformity (AFFD) When a combination of lengthening of anterior process and medial shift of tuber is indicated (usually in case of dorsolateral peritalar subluxation on weight-bearing radiographs) When deformity is still reducible/flexible…
Indications Flatfoot undergoing concomitant posterior tibial tendon (PTT) reconstruction with torn spring ligament Sag at the level of the talonavicular joint As an adjunct to medial column osteotomy and lateral column lengthening (if indicated) Indications Pitfalls Concurrent navicular–cuneiform joint laxity…
Indications Patient must first fail nonoperative measures for a minimum of at least 3–6 months. Stage I includes tenosynovitis without deformity that has been refractory to conservative treatment. Stages II–IV includes painful deformity with medial and/or lateral foot pain. Lateral…
Indications Painful type II accessory navicular Failure of conservative care Indications Pitfalls The accessory navicular has to be of sufficient size to accept a screw without fragmentation. If increased heel valgus has developed on the symptomatic side, a calcaneal osteotomy…