Indications Presence of a painful accessory navicular with or without flatfoot. Often associated with equinus contracture as well. Posterior tibial tendon function is usually intact but may be weakened secondary to pain. The enlarged area of the medial hindfoot may…
Charcot Neuroarthropathy Definition Charcot described neuroarthropathic arthropathy typically due to syphilis in the late 1880s. Although most current cases are due to diabetes, 20–30% of cases occur as a result of other neuropathic conditions: alcohol neuropathy, rheumatologic neuropathy, hereditary neuropathy,…
Indications Chronic midfoot pain that has failed orthotic treatment Advanced Mueller-Weiss disease with pain or deformity Fragmentation of the navicular Peri-navicular arthritis Indications Controversies Talonavicular-cuneiform arthritis requires a fusion of all of these joints Charcot neuroarthropathy Examination/Imaging Is the patient…
Indications Advanced stage of Mueller-Weiss syndrome ( Fig. 25.1 ) with Symptomatic osteoarthritis Progressive destabilization of the foot Secondary peritalar and midfoot pain due to tarsal destabilization Loss of neutral foot position that cannot be compensated by shoe modifications Indications…
Indications Fracture in zone II or III of the proximal fifth metatarsal (5MT; Fig. 24.1 ) Acute fracture in an athlete Delayed union Indications Pitfalls Varus hindfoot alignment maintaining a continued risk to 5MT overload. Treatment Options Nonoperative treatment with…
Indications Injuries to the talonavicular and calcaneocuboid joints (Chopart joints) are severe injuries often associated with an abduction force to the talonavicular joint and a lateral compression injury to the lateral column resulting in a “nutcracker” phenomenon. Precise examination and…
Indications Lisfranc/tarsometatarsal (TMT) injuries with instability and displacement Indications Pitfalls Displaced injuries lead to midfoot arthritis and often require later reconstruction with midfoot fusion. Indications Controversies ORIF versus immediate fusion. In the cervical spine, if one is treating a purely…
Indications Symptomatic acute sesamoid fracture, fracture-delayed union or nonunion, and congenital bipartite sesamoid bone after failure of conservative treatment for at least 6–8 weeks Acute sesamoid bone fracture or disruption of the synchondrosis between the sesamoid fragments of a bipartite…
Indications Relatively short metatarsal (brachymetatarsia; Fig. 20.1 ) Overload/transfer metatarsalgia to an adjacent metatarsal head Short first metatarsal (1MT) following corrective surgery for hallux valgus Indications Pitfalls Contraindicated for a dorsiflexion malunion of the 1MT, unless an adjunctive procedure can…
Indications Recurrent or persistent pain in the intermetatarsal space following excision of a Morton neuroma Exclusion of other sources of forefoot pain Transient relief from a focal injection of lidocaine Indications Pitfalls The incidence of continued forefoot pain after primary…