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- Author or Editor: MS Downey x
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The surgical alternatives for the treatment of tarsal coalitions include procedures as diverse as arthroplasty and arthrodesis. Traditional classifications of tarsal coalitions are primarily descriptive and afford little information regarding preferred treatment. For this reason, the author introduces the Articular Classification System, which is based on the patient's osseous age, the articular involvement of the coalition, and the associated secondary arthritic changes. This classification system can be used as a framework to discuss recommended surgical procedures and their long-term results.
The Kalish osteotomy has become a popular method for the correction of mild-to-moderate hallux abducto valgus deformities associated with metatarsus primus adductus. This paper reviews the common pitfalls associated with this procedure, including failure to observe the indications for the procedure, technical failures when performing the procedure, and the most frequent postoperative complications.
An updated and thorough review of the gastrocnemius equinus deformity and its surgical correction is presented. For the first time, a long-term retrospective study documents the overall improvement in the symptoms and architecture of the lower extremity and foot following gastrocnemius recession. Additionally, numerous associated concerns and the surgical procedure are examined retrospectively.
Autogenous Bone Graft Interpositional Arthrodesis for the Correction of Flail Toe
A Retrospective Analysis of 22 Procedures
Digital surgery is one of the most common types of surgery performed by foot and ankle surgeons. Flail toe is a complication that may occur after overaggressive resection arthroplasty of the proximal interphalangeal joint of the lesser toes. Correction of flail toe deformity has received little attention and has predominantly involved soft-tissue procedures. The authors’ preferred technique for the surgical correction of flail toe is to place a unicortical autogenous bone graft (harvested from the ipsilateral calcaneus) within the revised proximal interphalangeal joint of the lesser toes to create a distraction arthrodesis. This technique allows restoration of digital length, stability, and purchase. A retrospective review of 22 such procedures in 13 patients is presented, along with a literature review of other procedures and a description of the authors’ current surgical technique and postoperative management protocol. Overall success using the authors’ procedure was 82%. Complications occurred in three patients, with one of the grafts showing complete resorption and two requiring additional surgical intervention owing to nonunion and malunion of toes. (J Am Podiatr Med Assoc 93(3): 167-173, 2003)