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…
Indications Persistent symptomatic lateral ankle laxity following a lateral ligament procedure Failure of a physical therapy program that emphasizes peroneal strength, proprioception, and range of motion Inability to return to sports, even with the use of a brace Indications Pitfalls…
Indications Symptomatic chronic laxity of the lateral ankle with repeated sprains Limitation of activity Failure of an appropriate rehabilitation program Indications Pearls The anterior drawer test rotates the talus forward around the intact medial axis of the deltoid ligament complex…
Indications Symptomatic arthritis of the ankle Patients with compromised anterior tissue Prior lateral scar from fracture fixation, lateral ligament reconstruction, or peroneal tendon surgery Contralateral ankle fusion Symptomatic arthritis of the ankle with adjacent joint arthritis Ankle deformity that involves…
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 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…
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 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…
Indications Chronic pain and deformity of the forefoot from rheumatoid arthritis Recurrent ulceration Failure of nonoperative measures, including shoe modification and orthotics Indications Pitfalls Active infection or ulceration should be eradicated prior to surgery. Severe skin fragility may preclude operative…
Indications Chronic joint pain from advanced arthritis Severe deformity that limits activity or footwear Controversies Arthrodesis is the most commonly performed procedure for advanced symptomatic arthritis or severe deformity of the great toe. The end result is highly predictable, alleviates…