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A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis
Daniel PollackDepartment of Podiatric Surgery, Wyckoff Heights Medical Center, 374 Stockholm Ave, Brooklyn, NY 11237; Madison Podiatry, 52 Skyline Drive, Ringwood, NJ 07456. (E-mail: Dpollackdpm@gmail.com)
A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub–first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.