Indications Pitfalls Hallux varus must be reducible. Malunion of the metatarsal or proximal phalanx may preclude a simple soft-tissue correction. A negative intermetatarsal angle may require correction. Consider a fusion for an arthritic joint. Indications Controversies There are no long-term…
Indications Ongoing pain symptomatic enough to merit surgery Recurrent hallux valgus deformity Second metatarsalgia or overload Elevated first ray Plantar flexed first ray Hallux varus Avascular necrosis of the first metatarsal (MT) head Nonunion of osteotomy or arthrodesis Indications Pitfalls…
Indications Symptomatic moderate to severe hallux valgus (first/second intermetatarsal angle [1/2 IMA] >15°) failing nonoperative treatment Indications Pitfalls Contraindications to surgical correction of hallux valgus deformity: peripheral vascular disease and peripheral neuropathy Contraindication to surgical correction of hallux valgus with…
Indications Moderate to severe foot deformity, including Hallux valgus with metatarsus primus varus Hypermobility of the medial column Pes plano abductovalgus Examination/Imaging Physical Examination Upon weight bearing, hallux valgus is observed toward a more severe deformity. Proper examination of the…
Indications Painful hallux valgus deformity Failure of shoe modification Symptoms that interfere with daily activities A moderate to severe bunion deformity, with an intermetatarsal angle of ≥13° Hallux interphalangeus (HI) that causes great toe impingement on the second toe Indications…
Indications Objective Indications Moderate to severe hallux valgus deformities with Increased hallux valgus angle (HVA) ≤50° Increased intermetatarsal angle (IMA) ≤20° Increased distal metatarsal articular angle (DMAA) ≤10° Hallux valgus revision surgery for recurrence (Bock, 2009) Bunionette deformity of fifth…
Indications Painful hallux valgus deformity Failure of shoe modification Symptoms that interfere with daily activities A mild to moderate deformity (hallux valgus angle <30º; intermetatarsal angle [IMA] <13–15°) Patients with a high distal metatarsal articular angle (DMAA) require a chevron…
Total Knee Arthroplasty Outcome Instruments Critical Points Total Knee Arthroplasty Outcome Instruments Lack of consensus exists regarding which instrument or rating system should be selected, due in part to the moderate to poor quality of investigations that determined their psychometric…
Introduction Many grading systems have been proposed to classify lesions of the articular cartilage in the knee joint at arthroscopy; however, only a few are commonly used in modern orthopedic literature ( Table 44-1 ). The systems published in the…
Introduction This chapter reviews commonly used scales and outcome instruments that rate athletic and daily functional activities for a variety of knee injuries and disorders in younger active patients. The instruments are analyzed according to their strengths and potential biases…