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Foot and Ankle Surgery
Selene G Parekh
CHAPTER 1:
Surgical Anatomy of the Foot and Ankle
INTRODUCTION
THE ANKLE
Bones
Ligaments
THE FOOT
Bones
Ligaments
Plantar Fascia
Muscles and Tendons
Sensibility
Circulation
Toenails
SUMMARY
CHAPTER 2:
The Basics of the Foot and Ankle
INTRODUCTION
INSPECTION
Gait
DEFORMITY
Pes Planus
Pes Cavus
PALPATION
ANKLE
HINDFOOT AND MIDFOOT
Lateral Exam
Medial Exam
Forefoot
RANGE OF MOTION
Neurovascular
Special Tests
Anterior Drawer
Talar Tilt
Eversion
Squeeze
Tinel's Sign at the Ankle
Heel Percussion
Weinstein Monofilament
Thompson
Muscle Strength
GAIT ANALYSIS AND BIOMECHANICS OF THE FOOT AND ANKLE
Early Investigations
Gait
First Interval (0-15% of Walking Cycle)
Second Interval (15-40% of Walking Cycle)
Third Interval (40-62% of Walking Cycle)
Gait Abnormalities
Gait Motions
Kinematics
Sagittal (X-axis) Motions: Flexion-Extension Rotation
Frontal (Coronal, Z-axis) Motions: Inversion/Eversion Rotation
Transverse (Y-axis) Motions: Internal-External Rotation
Soft Tissues
Kinetics
EMG
Plantar Pressure and Force Measurements Methods
COMPONENT BIOMECHANICS
ANKLE JOINT
SUBTALAR JOINT
TRANSVERSE TARSAL ARTICULATION
METATARSOPHALANGEAL BREAK
Plantar Aponeurosis
IMAGING OF THE FOOT AND ANKLE
Foot
Anteroposterior Projection
Lateral Projection
Phalanges
SESAMOID BONES
Hindfoot
ANKLE
ANKLE STRESS VIEWS
NUCLEAR MEDICINE
COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
PET Imaging
SUMMARY
CHAPTER 3:
General Surgical Considerations in Foot and Ankle Patients
DETAILED HISTORY
PHYSICAL EXAM
IMAGING
SPECIAL PREOPERATIVE CIRCUMSTANCES
SURGERY
Positioning
Prepping and Draping
Common Surgical Techniques
Wound Closure
Postoperative Considerations
CHAPTER 4:
Hallux Valgus
DEMOGRAPHICS
GENDER AND BILATERALITY
CAUSES OF HALLUX VALGUS
Extrinsic Causes
Intrinsic Causes
ANATOMIC CONSIDERATIONS
PATHOANATOMY
CLINICAL EVALUATION
RADIOGRAPHIC EVALUATION
CONSERVATIVE TREATMENT
SURGICAL TREATMENT
Surgical Procedures
SURGICAL DECISION MAKING
CHEVRON OSTEOTOMY, BIPLANAR CHEVRON OSTEOTOMY, AND AKIN PROCEDURES
CHEVRON OSTEOTOMY TECHNIQUE
DSTP WITH OR WITHOUT PROXIMAL FIRST METATARSAL OSTEOTOMY
Distal Soft Tissue Procedure
Distal Soft Tissue Procedure (DSTP) Technique
MANN HV REPAIR (PROXIMAL CRESCENTIC OSTEOTOMY WITH DSTP)
Indications
Contraindications
Mann HV Repair (Proximal Crescentic Osteotomy with DSTP) Procedure
LUDLOFF/ PROXIMAL CHEVRON/ OPENING WEDGE WITH BOW PLATE
THE SCARF OSTEOTOMY
SCARF Osteotomy Technique
METATARSOPHALANGEAL ARTHRODESIS
FIRST METATARSOPHALANGEAL JOINT ARTHRODESIS
CHAPTER 5:
Lesser Toe Deformities and Sesamoid Pathology
INTRODUCTION
BASIC DEFINITIONS
HISTORY
PHYSICAL EXAMINATION
RADIOGRAPHIC EXAMINATION
MALLET TOE
General Considerations
Nonoperative Treatment
Operative Treatment
Author's Preferred Surgical Treatment
Flexible Mallet Toe—Flexor Tenotomy (Fig. 5.8)
Rigid Mallet Toe—DIP Arthrodesis (Fig. 5.9)
Results
HAMMER TOE
General Considerations
Nonoperative Treatment
Operative Treatment
Author's Preferred Surgical Treatment
Flexor Tendon Transfer (Figs 5.13A to K)
PIP Arthrodesis (Figs 5.14A to G)
Dorsal MTP Capsulotomy and Extensor Lengthening
Results and Complications
CLAW TOES
General Considerations
Nonoperative Management
Operative Treatment
Author's Preferred Surgical Technique
Flexor Tendon Transfer
PIP Arthrodesis
Dorsal MTP Capsulotomy and Extensor Lengthening (Figs 5.18A to E)
Weil Osteotomy
Results and Complications
MTP INSTABILITY
General Considerations
Nonoperative Treatment
Operative Treatment
Author's Preferred Surgical Techniques
Dorsal MTP Capsulotomy and Extensor Lengthening
Reefing of MTP Joint Capsule
Flexor Tendon Transfer
Weil Osteotomy (Figs 5.21A to K)
Results/Complications
FREIBERG'S INFRACTION
General Considerations
Nonoperative Treatment
Operative Treatment
Author's Preferred Surgical Techniques
Synovectomy and Cheilectomy
Closing Wedge Dorsiflexion (Capital) Osteotomy (Fig. 5.23)
DuVries Resection Arthroplasty (Fig. 5.24)
Results and Complications
BUNIONETTE DEFORMITY
General Considerations
Nonoperative Management
Operative Management
Author's Preferred Surgical Techniques
Lateral Condylectomy for Bunionette
Distal Chevron Osteotomy (Figs 5.28A to H)
Midshaft Oblique Osteotomy for Bunionette (Fig. 5.29)
Results and Complications
SESAMOIDS AND ACCESSORY BONES
Introduction
HALLUCAL SESAMOIDS
General Considerations
Patient Presentation
SPECIFIC SESAMOID CONDITIONS
Acute Fractures
Stress Fractures
Sesamoid Nonunion or Chronic Stress Fracture
Metatarsosesamoid Arthritis
Sesamoid Infection (Osteomyelitis)
Osteonecrosis
Sesamoiditis
Author's Preferred Surgical Technique
Medial Sesamoidectomy (Fig. 5.34)
Lateral Sesamoidectomy (Figs 5.35A to D)
Results and Complications
CHAPTER 6:
Nerve Disorders
INTERDIGITAL NEUROMA
Introduction
Anatomy
Pathogenesis
Examination
Diagnostic Studies
Treatment
Nonoperative Treatment
Surgical Treatment
TARSAL TUNNEL SYNDROME
Introduction
Anatomy
Pathogenesis
Examination
Diagnostic Studies
Treatment
Surgical Results
ENTRAPMENT OF FIRST BRANCH OF LATERAL PLANTAR NERVE
Introduction
Anatomy
Pathogenesis
Examination
Treatment
Medial Plantar Nerve Entrapment
SUPERFICIAL PERONEAL NERVE ENTRAPMENT
Anatomy
Pathogenesis
Examination
Treatment
Surgical Results
DEEP PERONEAL NERVE ENTRAPMENT
Anatomy
Pathogenesis
Examination
Treatment
ACKNOWLEDGMENT
CHAPTER 7:
Plantar Heel Pain
INTRODUCTION
RELEVANT ANATOMY
ETIOLOGY
HISTORY
PHYSICAL EXAMINATION
IMAGING AND FURTHER DIAGNOSTIC STUDIES
HEEL SPURS
TREATMENT OPTIONS
PLANTAR FASCIITIS NONOPERATIVE THERAPY
OPERATIVE THERAPY
TREATMENT OF ATHLETES WITH PLANTAR FASCIITIS
CRITERIA FOR RETURN TO SPORTS
TREATMENT OF CHILDREN
AUTHOR'S PREFERRED METHOD OF TREATMENT OF PLANTAR HEEL PAIN
CONCLUSION
CHAPTER 8:
Tumors of the Foot and Ankle
BONE TUMORS
Clinical Features
Radiologic Imaging
Biopsy
BENIGN BONE TUMORS
Osteochondroma
Enchondroma
Simple Bone Cyst and Intraosseous Lipoma
Osteoid Osteoma
Giant Cell Tumors (GCT)
Aneurysmal Bone Cyst (ABC)
Chondroblastoma
Chondromyxoid Fibroma (CMF)
Treatment of Benign Tumors
MALIGNANT BONE TUMORS
Radiographic Features
Serologic Investigations
Treatment of Malignant Bone Tumors
SOFT TISSUE TUMORS
Clinical Features
Radiographic Features
Biopsy
Treatment of Soft Tissue Tumors
CHAPTER 9:
Toenail Disorders
INTRODUCTION
TOENAIL ANATOMY
SYSTEMIC DISEASE
TOENAIL INFECTIONS
TUMORS
Nail Pigment Changes that Should be Biopsied
TOENAIL TRAUMA
TOENAIL SURGERY
CHAPTER 10:
Foot Arthritis
INTRODUCTION
HINDFOOT ARTHRITIS
PATHOPHYSIOLOGY AND ETIOLOGY
Anatomy
Demographics
Etiopathophysiology
Post-traumatic Arthritis
Primary (Idiopathic) Arthritis
Inflammatory Arthritis
Neuropathic Arthropathy
Other Causes
DIAGNOSIS
Patient History
Physical Examination
Radiographic Evaluation
Classification
MANAGEMENT
Nonoperative Treatment
Operative Treatment
Operative Indications
Contraindications to Operative Treatment
Isolated Subtalar Fusion
Triple Arthrodesis
Isolated Talonavicular Arthrodesis
Alternative Arthrodesis Techniques
SUMMARY
MIDFOOT ARTHRITIS
PATHOPHYSIOLOGY AND ETIOLOGY
Anatomy
Demographics
Etiopathophysiology
Post-traumatic Arthritis
Primary (Idiopathic) Arthritis
Inflammatory Arthritis
Neuropathic Arthropathy
DIAGNOSIS
Patient History
Physical Examination
Radiographic Evaluation
Classification
MANAGEMENT
Nonoperative Treatment
Operative Treatment
Operative Indications
Contraindications to Operative Treatment
Standard Tarsometatarsal Joint Arthrodesis: In Situ or with Joint Realignment
Wedge Resection Realignment Arthrodesis
Interpositional Tendon Arthroplasty of the Lateral Column
SUMMARY
FORE FOOT
HALLUX RIGIDUS
PATHOPHYSIOLOGY AND ETIOLOGY
Demographics
Etiology
Pathophysiology
DIAGNOSIS
History
Physical Examination
Radiographic Evaluation
Classification
MANAGEMENT
Nonoperative Management
Joint Sparing Procedures
Cheilectomy
Indications
Contraindications
Proximal Phalanx Osteotomy
Distal Metatarsal Osteotomy
Other Osteotomy Procedures
Joint Destructive Procedures
Keller Resection Arthroplasty
Interpositional Arthroplasty
Valenti Procedure
MTP Joint Arthrodesis
Total MTP Joint Replacement Arthroplasty
MTP Joint Hemiarthroplasty
SUMMARY
CHAPTER 11:
Arthritis of the Ankle
INTRODUCTION
ETIOLOGY
CLINICAL EVALUATION
IMAGING
MANAGEMENT GOALS
Conservative Management
Operative Management
ARTHROSCOPIC DEBRIDEMENT
Indications and Contraindications
Surgical Technique
Positioning
Portal Placement
Ankle Distraction
Debridement
Closure of Incisions and Postoperative Protocol
Complications
Outcomes
ANKLE ARTHRODESIS
Indications and Contraindications
Surgical Technique
External Fixation
Arthroscopic Arthrodesis
Open Arthrodesis
Complications
Outcomes
ANKLE ARTHROPLASTY
Indications and Contraindications
Surgical Technique
Preoperative Planning
Positioning
Anterior Surgical Approach
Tibial Preparation
Talar Preparation
Implantation
Closure of Incision and Postoperative Protocol
Complications
Outcomes
SUMMARY
CHAPTER 12:
Pes Planus Deformity
INTRODUCTION
ANATOMY
HISTORY
PHYSICAL EXAMINATION
CLASSIFICATION
Stage I: Tenosynovitis without Deformity
Stage II: Ruptured Posterior Tibial Tendon and Flexible Pes Planus
Stage III: Rigid Hindfoot Valgus
Stage IV: Ankle Valgus
IMAGING
Nonsurgical Treatment of Pes Planus Deformity
SURGICAL TREATMENT OF PES PLANUS DEFORMITY
PTT Debridement (Stage I)
Medial Sliding Calcaneal Osteotomy
Lateral Column Lengthening
Flexor Digitorum Longus Transfer
Naviculocuneiform Fusion
Arthroereisis
Triple Arthrodesis13
Deltoid Ligament Reconstruction17
Tibiotalocalcaneal Arthrodesis2,15
CHAPTER 13:
Pes Cavus Deformity
BIOMECHANICS
ETIOLOGY
Charcot-Marie-Tooth Disease
Friedreich Ataxia
Dejerine-Sottas Syndrome
Roussy-Levy Syndrome
Poliomyelitis
Postpolio Syndrome
Residual Congenital Clubfoot
Polyneuritis
Muscular Dystrophy
Spinal Cord Abnormalities
Cerebral Palsy
Post-traumatic
Compartment syndrome
Malunion/Malalignment/Burns
Congenital Hypomyelination
Arthrogryposis Multiplex Congenita
Idiopathic
PHYSICAL EXAMINATION
RADIOGRAPHS
CONSERVATIVE TREATMENT
SURGICAL TREATMENT
PLANTAR FASCIA RELEASE
DORSAL WEDGE OSTEOTOMY
DWYER OSTEOTOMY21
SAMILSON OSTEOTOMY65,66
Malerba Z-shaped Calcaneal Osteotomy50
Peroneus Longus to Peroneus Brevis Tendon Transfer
Transfer of the Extensor Hallucis Longus to the First Metatarsal (Jones Procedure, First Toe)6,86
Flexor Digitorum Longus Transfer to the Extensor Sheath (Girdlestone -Taylor Procedure)22,77
Extensor Digitorum Longus Transfer and PIP Joint Fusions (Chuinard-Baskin Procedure)11
Akron Dome Midfoot Osteotomy87,89
Siffert “Beak” Triple Arthrodesis72
After the Operation
SUMMARY
CHAPTER 14:
Tendon Disorders
FLEXOR HALLUCIS LONGUS TENDON
Anatomy
Pathological Conditions of the Flexor Hallucis Longus Tendon
History and Physical Examination
Radiographic Examination
Treatment
Authors’ Preferred Surgical Treatment for Flexor Hallucis Longus Stenosing Tenosynovitis
Flexor Hallucis Longus Tendon Laceration
ANTERIOR TIBIAL TENDON
Anatomy
Pathologic Conditions of the Anterior Tibial Tendon
History and Physical Examination
Imaging
Treatment
Authors’ Preferred Treatment for Acute Anterior Tibial Tendon Rupture
Authors’ Preferred Treatment for Chronic Ruptures
PERONEAL TENDON DISORDERS
Anatomy
Peroneal Tendon Subluxation and Dislocation
History and Physical Exam
Imaging
Treatment
Authors’ Preferred Surgical Treatment for Acute Peroneal Subluxation or Dislocation
Authors’ Preferred Surgical Treatment for Chronic Peroneal Tendon Subluxation or Dislocation
Peroneal Tendon Tears
History and Physical Exam
Imaging
Treatment
Authors’ Preferred Surgical Treatment for Peroneal Tendon Tears
Peroneal Tendinopathy and Painful Os Peroneum Syndrome
History and Physical Exam
Imaging
Treatment
Authors’ Preferred Surgical Treatment of Peroneal Tendinopathy
Authors’ Preferred Surgical Treatment for Painful Os Peroneum Syndrome
POSTERIOR TIBIAL TENDON DISORDERS
Anatomy
Traumatic Laceration of the Posterior Tibial Tendon
Imaging
Treatment
Authors’ Preferred Surgical Treatment for Posterior Tibial Tendon Laceration
Dislocation of the Posterior Tibial Tendon
Treatment
Authors’ Preferred Surgical Treatment for Posterior Tibial Tendon Dislocation
Symptomatic Accessory Navicular
History and Physical Exam
Imaging
Treatment
Authors’ Preferred Surgical Treatment for the Symptomatic Accessory Navicular
Posterior Tibial Tendon Deficiency (PTTD) and Adult Acquired Flat-Foot Deformity
History and Physical Exam
Stage 1
Authors’ Preferred Surgical Treatment for Stage 1 PTTD
Stage 2
Authors’ Preferred Surgical Treatment for Stage 2 PTTD
Stages 3 and 4
Authors’ Preferred Surgical Treatment for Stage 3 PTTD
DISORDERS OF THE ACHILLES TENDON
Anatomy
Tendinosis
Authors’ Preferred Surgical Treatment of Achilles Tendinosis with Single Incision
Author's Preferred Surgical Treatment of Achilles Tendenosis with Two Incisions
Paratenonitis
Authors’ Preferred Surgical Treatment of Achilles Paratenonitis
Insertional Achilles Tendinitis
Retrocalcaneal Bursitis
Authors’ Preferred Surgical Treatment of Insertional Tendinitis and Retrocalcaneal Bursitis
Acute Achilles Tendon Ruptures
Authors’ Preferred Surgical Treatment of Acute Achilles Tendon Rupture
Chronic Achilles Tendon Rupture
Authors’ Preferred Surgical Treatment for Chronic Achilles Rupture
CONCLUSION
CHAPTER 15:
Diabetic Foot
INTRODUCTION
EPIDEMIOLOGY OF DIABETES MELLITUS IN INDIA
MEDICAL CONSIDERATIONS
ULCERATION
Introduction
Pathophysiology
History
Classification
Healing Capacity
Vascular Reconstruction
Prevention
Screening for Peripheral Neuropathy
Treatment
Nonoperative Therapy
Surgical Management of Ulcers
Charcot Neuroarthropathy
History
Eichenholtz Classification
Midfoot Charcot Collapse
Description
Plantar Plating Technique
Sammarco Technique
Ankle Contractures
Decision on which Technique to Use
Percutaneous Achilles Lengthening (Hoke)
Gastrocnemius Recession (Strayer)
Infection
TRAUMA
IMPAIRED FRACTURE HEALING
TREATMENT
OPERATIVE TECHNIQUES
Trans- or Periarticular Pin Fixation
En Peign Fixation
SALVAGE
TTC Bone Block Fusion
CONCLUSION
CHAPTER 16:
Neuropathic Foot
INTRODUCTION
PATHOPHYSIOLOGY OF CHARCOT NEUROARTHROPATHY
CLINICAL PRESENTATION
Classification
Pattern of Collapse
IMAGING OF THE CHARCOT FOOT AND ANKLE
NONSURGICAL TREATMENT
Offloading and Immobilization
Pharmacological Treatment
SURGICAL TREATMENT
Treatment of Acute Fracture in the Neuropathic Foot
Exostectomy
Percutaneous Tendo-Achilles’ Lengthening (PTAL)
Arthrodesis
Arthrodesis in Eichenholtz Stage 1
Midtarsal Arthrodesis
Amputation
Below-Knee Amputation with Tibiofibular Bridge Synostosis
Syme Amputation
CONCLUSION
CHAPTER 17:
Orthotics and Prosthetics for the Foot and Ankle
POSTOPERATIVE EDEMA MANAGEMENT
MATERIALS
Accommodative Materials
Shock Absorbing
Loading Materials
POSTOPERATIVE ORTHOTIC MANAGEMENT
Forefoot
Midfoot
Hindfoot
POSTOPERATIVE PROSTHETIC CARE
CONCLUSION
CHAPTER 18:
Amputations of the Foot and Ankle
INTRODUCTION
GENERAL CONSIDERATIONS
Indications for Amputation
Level of Amputation
Presurgical Testing
Multidisciplinary Care
Pain Management
Psychosocial Aspects
Prehabilitation and Rehabilitation
SURGICAL CONSIDERATIONS
Tourniquets
Addressing Neurovascular Structures
Wound Closure, Soft Tissue Coverage and Cosmesis
Postoperative Dressings
SURGICAL TECHNIQUE
Amputation of Distal Toe
Amputation of Lesser Toes
Amputation of Great Toe (through Proximal Phalanx Base)
Amputation of Great Toe (through Metatarsophalangeal Joint)
Border Ray Resection
Central Ray Resection
Transmetatarsal Amputation (TMA) and Tarsometatarsal Disarticulation (Lisfranc's Amputation)
Transtarsal Joint Amputation (Chopart's Amputation)
Transcalcaneal Amputations (Boyd and Pirogoff Amputations)
Ankle Disarticulation (Syme's Amputation)
Transtibial Amputation / Below Knee Amputation (BKA)
Ertl Modification of Transtibial Amputation (Tibiofibular Bridge)
CONCLUSION
CHAPTER 19:
Athletic Injuries of the Foot and Ankle
INTRODUCTION
ANKLE AND SUBTALAR JOINTS
Lateral Ankle Sprain
Anatomy
Mechanism and Grading of Injury
Nonoperative Treatment
Operative Treatment
Chronic Lateral Ankle Instability and Associated Pathologies
Authors’ Preferred Surgical Technique of Anatomic Repair of the Lateral Ankle Ligaments
Medial Ankle Sprain
Anatomy
Mechanism of Injury
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Technique of Anatomic Repair of the Deltoid Ligament
Ankle Syndesmotic Injury
Anatomy
Mechanism of Injury
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Technique of Syndesmotic Fixation
Osteochondral Lesions of the Talus (OCLs)
Anatomy
Mechanism of Injury
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Technique of Microfracture Treatment of the Talar OCLs
Ankle Impingement Syndromes
Anatomy and Mechanism of Injury
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Technique of Arthroscopic Debridement of the Anterior Ankle Impingement
Posterior Ankle Impingement
Anatomy and Mechanism of Injury
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Technique of Arthroscopic Treatment of the Posterior Ankle Impingement
HINDFOOT
Plantar Fasciitis/ Plantar Heel Pain
Anatomy
Mechanism of Injury
Diagnosis
Nonoperative Treatment
Operative Treatments
Plantar Fascia Rupture
Flexor Hallucis Longus Tendonitis
Anatomy
Diagnosis
Nonoperative Treatment
Operative Treatment
Posterior Tibial Tendon Disorders
Anatomy and Mechanism of Injury
Posterior Tibial Tendon Tenosynovitis
Authors’ Preferred Surgical Treatment of Posterior Tibial Tenosynovitis
Posterior Tibial Tendon Rupture
Authors’ Preferred Surgical Treatment of Posterior Tibial Tendon Rupture
Dislocation of Posterior Tibial Tendon
Authors’ Preferred Surgical Treatment of Posterior Tibial Tendon Dislocation
Peroneal Tendons Disorders
Anatomy
Peroneal Tenosynovitis
Peroneal Tendon Tear
Peroneal Tendon Subluxation and Dislocation
Authors’ Preferred Surgical Treatment of Peroneal Tendon Subluxation and Dislocation
Achilles Tendon Disorders
Anatomy and Pathophysiology
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Treatment of Noninsertional Achilles Tendinopathy by Open Debridement with Possible FHL Tendon Transfer
Complete Rupture of the Achilles Tendon
Retrocalcaneal Bursitis
Haglund's Deformity
Authors’ Preferred Surgical Treatment of Haglund Syndrome by Open Debridement with Possible FHL Tendon Transfer
MIDFOOT
Lisfranc Fracture Dislocation
Anatomy
Mechanism of Injury
Diagnosis
Treatment
Authors’ Preferred Treatment of Lisfranc Injuries
Accessory Navicular Syndrome
Anatomy
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Treatment of Symptomatic Accessory Navicular in Adults
FOREFOOT
Metatarsophalangeal Joint Injuries/Turf Toe
Anatomy
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Treatment of a Severe Turf Toe Injury
Sesamoid Disorders
Anatomy
Diagnosis
Nonoperative Treatment
Operative Treatment
Authors’ Preferred Surgical Treatment of Sesamoid Disorders by Sesamoid Excision
STRESS FRACTURES
Patient Evaluation
Treatment
Distal Tibial Stress Fracture
Diagnosis
Treatment
Calcaneus Stress Fracture
Navicular Stress Fractures
Authors’ Preferred Surgical Treatment of Navicular Stress Fracture by Percutaneous Screw Fixation
Second, Third and Fourth Metatarsal Stress Fractures
Fifth Metatarsal Stress Fracture
Authors’ Preferred Surgical Treatment of 5th Metatarsal Stress Fracture by Intramedullary Screw Fixation
CHAPTER 20:
Stress Fractures of the Foot and Ankle
INTRODUCTION
EPIDEMIOLOGY
APPROACH TO STRESS FRACTURES
History
Physical Examination
Radiographs
SPECIFIC STRESS FRACTURES
Medial Malleolar Stress Fractures
Navicular Stress Fractures
Metatarsal Stress Fractures
Fifth Metatarsal Stress Fractures
Stress Fractures of the Calcaneus
Stress Fracture of the Sesamoids
CONCLUSION
CHAPTER 21:
Arthroscopy of the Foot and Ankle
INTRODUCTION
INDICATIONS AND CONTRAINDICATIONS
ANESTHESIA
EQUIPMENT
POSITIONING/DISTRACTION
ARTHROSCOPIC ANATOMY AND PORTALS
ARTHROSCOPIC DIAGNOSTIC EXAMINATION
ARTHROSCOPIC TECHNIQUE FOR TREATING COMMON DISORDERS
Loose Bodies
Impingement
Osseous Impingement
Soft Tissue Impingement
OSTEOCHONDRAL LESIONS OF THE TALUS (OLT)
ARTHROSCOPIC ANKLE ARTHRODESIS
ARTHROSCOPIC SUBTALAR ARTHRODESIS
COMPLICATION
CONCLUSION
CHAPTER 22:
Pediatric Foot and Ankle
INTRODUCTION
DIAGNOSES OF THE NEWBORN
CALCANEOVALGUS FOOT
VERTICAL TALUS
CALCANEOVARUS FOOT
METATARSUS ADDUCTUS
Clubfoot
Polydactyly
Syndactyly
Macrodactyly
Longitudinal Epiphyseal Bracket
Curly Toes
DIAGNOSES OF THE CHILD UP TO AGE 10
Flexible Flatfoot
Köhler's Disease
Sever's Syndrome
DISORDERS IN CHILDREN OVER 10 YEARS
Accessory Navicular
Tarsal Coalition
Os Trigonum Syndrome
Freiberg's Infraction
Planovalgus Foot and Skewfoot
Pes Cavus
Juvenile Hallux Valgus
Osteochondral Lesions of the Talus
Ankle Instability
Subungual Exostosis
Neuromuscular Disorders
CHAPTER 23:
Soft Tissue and Skin Disorders of the Foot and Ankle
COMPLEX REGIONAL PAIN SYNDROME (REFLEX SYMPATHETIC DYSTROPHY)
Altered Sensations
Physiology of CRPS
Incidence
Physical Exam
Diagnostic Evaluation
TREATMENT
Physical Therapy
Nonpharmacologic Option
Acupuncture
Nerve Blocks
Pharmacologic Agents
Vitamin C
Pain Therapies
Newer Horizons
Surgical Treatment
CHAPTER 24:
Infections of the Foot and Ankle
CLASSIFICATION
Patient-dependent Factors
Anatomical Location
Involved Organisms
MEDICALLY IMPORTANT BACTERIA
Staphylococcus
Streptococcus
Neisseria
Clostridium
Pasteurella Multocida
Pseudomonas Aeruginosa
Borrelia Burgdorferi
FUNGUS
Tinea Pedis
Onychomycosis
Mycetoma (Madura Foot)
MYCOBACTERIA
Mycobacterium Tuberculosis
ANTIBIOTICS
Penicillins
Cephalosporins
Cephamycins
Monobactams
Carbapenems
Vancomycin
Clindamycin
Macrolides
Aminoglycosides
Fluoroquinolones
Trimethoprim-Sulfamethoxazole
Linezolid
SOFT TISSUE INFECTIONS
Erythrasma
Paronychia
Felon
Puncture Wounds
Animal Bites
Necrotizing Fasciitis
OSTEOMYELITIS
SEPTIC ARTHRITIS
CHAPTER 25:
Trauma of the Foot and Ankle
INTRODUCTION AND EPIDEMIOLOGY
CLASSIFICATIONS
Danis-Weber Classification
AO/OTA Classification
Lauge Hansen Classification
Unique Fractures Requiring Special Mention
Evaluation
X-ray Interpretation
Management
Initial Management
Nonoperative Care
Indications for Surgery
Surgical Technique
Syndesmosis Fixation
Open Fractures
Diabetes and Ankle Fractures
Postoperative Management
Outcomes
Complications
Summary
HINDFOOT INJURIES
Calcaneus Fractures
Treatment
Complications
Outcomes
Talus Fractures
Talar Neck Fractures
Treatment
Timing of Surgery
Complications
Outcomes
Lateral Process Fractures
Medial Process Fractures
Talar Body Fractures
Associated Injuries
Subtalar Dislocations
Midfoot Injuries
Navicular Fractures
Cuboid Fractures
Lisfranc Fracture Dislocation
Treatment
Outcomes
Complications
First Metatarsal
Fifth Metatarsal
Second to Fourth Metatarsals
Phalangeal Fractures
Compartment Syndrome
INDEX
TOC
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