Clinics in podiatric medicine and surgery最新文献

Lapidus is a common procedure in our armamentarium for the treatment of hallux valgus deformity. This study presents to the reader that it can be performed percutaneously. It is a technically difficult procedure to perform that requires didactic and cadaveric percutaneous training.

Complex forefoot deformities are challenging to treat and are labor intensive for the surgeon and the patient. New minimally invasive surgery (MIS) shows great potential and in some instances outperforms traditional open surgery. Another advantage MIS has is that it is technically easier to perform (once proficient) and produces less pain and recovery for the patient. This article takes the reader through MIS preoperative planning, soft tissue considerations, the different osteotomy configuration options, rationale, transverse plane correction, sagittal plane correction, revision MIS surgery of malunions, metatarsus adductus correction, hybrid MIS correction, and postoperative bandaging and management.

New minimally invasive bunion surgery for hallux valgus (HV) has received attention in the last few years. A rapid growth in knowledge and techniques has been seen, with many publications, books, and experienced surgeons worldwide. Several variational advancements have emerged with the most common as a percutaneous subcapital osteotomy first metatarsal with long scaffolding minimally invasive (MI) screw placement. MI techniques are a great advancement in the treatment of all HV severities. Supportive literature has demonstrated that MI can achieve equal to better results compared to traditional open surgery, for metrics such as satisfaction, pain, and time to full recovery.

Hallux valgus recurrence after traditional open bunion surgery is a notable concern. New minimally invasive bunion surgery (MIBS) offers a promising new revision option for those with recurrent hallux valgus. This innovative approach signifies a noteworthy departure from traditional open surgical methods by minimizing tissue damage, allowing immediate weight bearing, and providing improved patient satisfaction outcomes. This article provides is insights into this emerging method, case examples, and key surgical treatment pearls for treating the recurrent bunion with MIBS. As more surgeons gain MIBS experience, this approach will likely become the gold standard revision method for revisions.

Minimally invasive surgery is gaining tremendous popularity in reconstructive foot and ankle surgery, as well as with trauma. Minimally invasive approaches have demonstrated equivalent to outcomes to traditional open incisional approaches with the added benefit of less risk for wound healing complications and surgical site infections. Advances in orthopedic hardware and surgical techniques are allowing minimal incision surgery for trauma to become more widespread. While there is a steeper learning curve to become proficient, minimally invasive surgery is likely to become the standard for most foot and ankle trauma cases.

Over the last 5 years, minimally invasive surgery (MIS) has seen a significant surge, propelled by advancements in surgical equipment, implants, methodologies, and comprehensive education. The introduction of specialized hardware and advanced bone-cutting burrs has contributed to a reduction in complications. Evidence from peer-reviewed studies suggests that the outcomes of MIS are often on par with, and at times surpass, those of traditional surgical methods. In the context of MIS, certain complications are specifically linked to the use of burrs and hardware, the types of deformities being addressed, and the tools utilized. This article aims to discuss these complications associated with MIS.

Syndesmotic ankle injuries, though rare in isolation, are complex destabilizing injuries often accompanied by fractures. Misdiagnoses, particularly overlooking posterior malleolus fractures, are common in ankle sprains. Thorough physical examinations, emphasizing high fibular pain and anterior tibia palpation, aid in accurate diagnosis. Grading helps assess injury severity and guiding treatment. Initial imaging involves three ankle views, with stress radiographs enhancing accuracy. If conservative care fails, MRI reveals ligament and tendon damage. Physical therapy may suffice for functional instability; surgical intervention addresses mechanical instability. Syndesmotic fixation debates center on cortices, screw size, reduction methods, and optimal positioning.

Metatarsal fractures are some of the most common fractures reported in the human body. Recent advances in surgical techniques and fixation have helped facilitate healing and improved outcomes for our patients. The treatment goals of metatarsal fractures are to maintain the metatarsal parabola, sagittal position of the metatarsal heads, and a congruent metatarsophalangeal joint. Most of these injuries can be treated nonoperatively, but displaced fractures require surgical intervention to preserve normal gait biomechanics.