Search Results
This article describes a proximal phalangeal osteotomy for the correction of abductus deformity of the hallux. The modification uses a Z-osteotomy, which retains the length of the hallux, corrects the abductus component, and provides excellent rigid internal fixation. This procedure may be used only in mild-to-moderate cases. (J Am Podiatr Med Assoc 94(4): 404–408, 2004)
Many procedures have been described for the resection of plantar calcaneal spurs as treatment of heel spur syndrome and chronic plantar fasciitis. Most of these techniques involve a medial incision of between 2 and 6 cm for adequate exposure of the calcaneal spur. This article describes a new technique for resecting a calcaneal spur with a smaller medial incision using the holmium:yttrium-aluminum-garnet (Ho:YAG) laser. This laser permits adequate resection of a plantar calcaneal spur as well as coagulation of the bone and surrounding tissues. This minimally invasive procedure has been used with good results over the past year by the senior author (W.K.S.) for the resection of calcaneal spurs. (J Am Podiatr Med Assoc 91(3): 142-146, 2001)
Subtalar Arthroereisis for Pediatric Flexible Pes Planovalgus
Fifteen Years Experience with the Cone-shaped Implant
Flexible pes planovalgus is a common condition with flattening of the medial longitudinal arch accompanied by hindfoot valgus. Severe cases of pes planovalgus may need surgery, and a technique that has gained popularity over the past decades is subtalar arthroereisis. An endoorthotic implant of various shapes is inserted in the sinus tarsus, which limits the excessive eversion of the subtalar joint present in flexible pes planovalgus. None of these implants, however, allow for easy control of the extent of talocalcaneal and talonavicular correction. The primary aim of this study was to describe our technique with the custom-built cone-shaped implant. Our secondary aim was to evaluate patient satisfaction, clinical and radiologic results, and complications with a minimal follow-up of 5 years. Between January 1992 and June 2002, 40 patients (80 feet) underwent subtalar arthroereisis for flexible pes planovalgus. After temporary sinus tarsi tenderness (12 feet), implant dislocation (two feet) was the most common complication. Questionnaires from 27 patients (54 feet) were analyzed and 44 feet were also clinically and radiographically evaluated. Thirteen patients were lost to follow-up. Mean (± SD) follow-up was 12.6 years (range, 5.9–16.1). Eighty-one percent of the patients were satisfied with the result. Clinically, normal alignment was present in 14 feet, and mild deformities remained in 26 feet. Radiographically, the average foot angle measurements were normal. We conclude that subtalar arthroereisis is a simple, minimally invasive operative option with satisfactory subjective and clinical results after mid- to long-term follow-up. (J Am Podiatr Med Assoc 99(5): 447–453, 2009)
