RESUMEN
Postoperative complications can be burdensome on both the patient and the surgeon. Attention in literature is often directed toward different forms of treatment and successful outcomes in surgery. The incentive of this article is to bring insight toward postoperative complications in rearfoot surgery, more specifically, the repair of the Achilles tendon with suture tape and suture anchors. This article directs attention to the recent reports on hypersensitivity reactions seen with the use of suture tape and nonabsorbable suture anchors and may encourage physicians to make patients aware of this potential complication when using these materials.
Asunto(s)
Tendón Calcáneo/cirugía , Complicaciones Posoperatorias , Tendón Calcáneo/lesiones , Anciano , Reacción a Cuerpo Extraño/etiología , Reacción a Cuerpo Extraño/cirugía , Humanos , Hipersensibilidad/etiología , Hipersensibilidad/cirugía , Masculino , Persona de Mediana Edad , Rotura Espontánea , Cinta Quirúrgica/efectos adversos , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/prevención & control , Anclas para Sutura/efectos adversos , Tendinopatía/etiología , Tendinopatía/prevención & control , Trombosis de la Vena/etiología , Trombosis de la Vena/prevención & controlRESUMEN
Revision surgeries, as well as conversions from implants to arthrodesis, can present unique challenges to the foot and ankle surgeon. Proper perioperative planning assists in optimizing the outcome of the procedure. In general, some amount of bone loss and/or shortening of the first metatarsal takes place, leading to the need for augmenting the site with bone graft or a synthetic substitute. Fixation also plays a key role in obtaining a successful conversion. A solid construct combined with bone graft assists the foot and ankle surgeon in achieving an optimal outcome.
Asunto(s)
Artrodesis/instrumentación , Artroplastia de Reemplazo/instrumentación , Hallux , Prótesis Articulares , Articulación Metatarsofalángica , Trasplante Óseo , Femenino , Humanos , Persona de Mediana Edad , ReoperaciónRESUMEN
Early avascular necrosis of metatarsal heads and cuboid injuries are uncommon conditions encountered by foot and ankle specialists. Treatment options are limited and typically include long periods of offloading or non-weightbearing. There is limited published information on alternative treatment approaches for such pathologies when conservative therapies fail. Presented are 2 patient cases treated with a percutaneous calcium phosphate injection after failure of standard therapy, persistent pain, and bone marrow edema in the foot.
Asunto(s)
Fosfatos de Calcio/uso terapéutico , Fracturas por Estrés/terapia , Huesos Metatarsianos , Osteonecrosis/terapia , Huesos Tarsianos/lesiones , Adulto , Femenino , Fracturas por Estrés/complicaciones , Fracturas por Estrés/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Osteonecrosis/complicaciones , Osteonecrosis/diagnóstico por imagenRESUMEN
Hallux varus is a deformity of acquired and less commonly congenital etiologies. It can present secondary to the release of the soft tissues surrounding the first metatarsophalangeal joint surfaces during bunion surgery. If the condition is left untreated, it can be debilitating, with progressive pain and destruction of joint surfaces. Many procedures have been described for the treatment of iatrogenic causes of hallux varus; however, little has been reported regarding the success of procedures when used for less typical traumatic causes. In the present report, a case is presented of surgical repair of a traumatic hallux varus using a suture and button fixation device and 3-year patient follow-up data.
Asunto(s)
Hallux Varus/cirugía , Rotura/cirugía , Anclas para Sutura , Traumatismos de los Tendones/complicaciones , Traumatismos de los Tendones/cirugía , Accidentes por Caídas , Adulto , Estudios de Seguimiento , Traumatismos de los Pies/diagnóstico por imagen , Traumatismos de los Pies/cirugía , Hallux Varus/diagnóstico por imagen , Hallux Varus/etiología , Humanos , Puntaje de Gravedad del Traumatismo , Imagen por Resonancia Magnética/métodos , Masculino , Procedimientos Ortopédicos/métodos , Rotura/complicaciones , Rotura/diagnóstico por imagen , Traumatismos de los Tendones/diagnóstico por imagen , Resistencia a la Tracción , Resultado del Tratamiento , Cicatrización de Heridas/fisiologíaRESUMEN
Ankle arthritis can be broadly classified as primary arthritis (nontraumatic degeneration) or secondary arthritis (post-traumatic degeneration). A good understanding of the anatomic features and presentations associated with each will assist the surgeon in determining the best course of action for each patient. Many variations of both primary and secondary arthritis can be treated conservatively; however, there are many times when conservative therapy is not adequate. In these cases, ankle arthroscopy may be considered before a joint fusion or replacement. Here, the authors discuss the common types of ankle arthritis, their presentations, and treatment success with ankle arthroscopy.
Asunto(s)
Articulación del Tobillo/cirugía , Artroscopía , Osteoartritis/cirugía , Articulación del Tobillo/anatomía & histología , Humanos , Osteoartritis/terapiaRESUMEN
First metatarsocuneiform joint arthrodesis has been used in foot and ankle surgery for the treatment of hallux abductovalgus deformity, among other pedal pathologic entities. The goal of the present retrospective study was to compare the fusion rates and complications of an intraplate compression screw fixation, crossing solid core screw fixation, and a single interfragmentary screw with a simple locking plate. All procedures were performed by a single surgeon, and all patients received an identical postoperative protocol. A medical record review was performed of 147 evenly distributed surgical methods. All patients were non-weightbearing by protocol for 4 weeks. The patient covariates included sex, age, nicotine status, osteoporosis, and diabetes. These variables were balanced among the treatment groups and were noncontributory, with the exception of sex. Male patients had a 6 times greater odds of experiencing nonunion. The overall nonunion rate was 6.7%, with 4% symptomatic and requiring revision. The individual nonunion rates for each method were 2% for intraplate compression screw fixation, 5% for single interfragmentary screw with locking plate fixation, and 9% for crossing solid core screw fixation. None of the differences reached statistical significance. The corresponding hardware removal rates were 12%, 11%, and 0%.
Asunto(s)
Artrodesis/métodos , Tornillos Óseos , Hallux Valgus/cirugía , Adulto , Artrodesis/efectos adversos , Placas Óseas , Femenino , Hallux Valgus/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Radiografía , Estudios Retrospectivos , Factores Sexuales , Insuficiencia del TratamientoRESUMEN
In recent years, arthroscopic procedures of the foot and ankle have seen a significant increase in both indications and popularity. Furthermore, technological advances in video quality, fluid management, and other arthroscopy-specific instruments continue to make arthroscopic procedures more effective with reproducible outcomes. As surgeons continue to use this approach, it is important that they have a complete understanding of the instrumentation available to them, including their indications and limitations.
Asunto(s)
Artroscopía/instrumentación , Articulaciones del Pie/cirugía , HumanosRESUMEN
This article discusses four subsets of patients that have an increased risk of complications from tendon surgery in the foot and ankle: smokers, diabetics, and patients with peroneal or Achilles tendon pathology. Very little has been published on the complications of other tendon surgeries in the foot and ankle other than Achilles tendon repair. Data can be extrapolated from the general orthopedic literature and animal studies to help guide therapy and treatment options. The foot and ankle surgeon must take into account the entirety of the history and physical examination to develop a treatment plan that optimizes each patient's chance for a complication-free recovery.
Asunto(s)
Pie/cirugía , Complicaciones Posoperatorias , Tendones/cirugía , HumanosRESUMEN
Checkrein deformities are rare and involve entrapment or tethering of the flexor hallucis longus and, occasionally, flexor digitorum longus tendons. The deformity has typically been secondary to traumatic fractures of the talus, calcaneus, or deep posterior compartment syndrome resulting from fractures of the tibia and fibula and most fractures of the ankle. These result in flexion contractures at the interphalangeal joint of the hallux. Because of the rarity of this deformity, no single surgical technique has been defined as the standard. Previous interventions have included release of adhesions with or without Z-plasty lengthening of the involved tendons. The present study reports a case of checkrein deformity secondary to a malunited distal tibia fracture, with flexion deformities to digits 1 through 3. The patient underwent successful surgical correction with flexor tenotomies to the affected digits with interphalangeal arthrodesis to the hallux.
Asunto(s)
Contractura/cirugía , Deformidades Adquiridas del Pie/cirugía , Fracturas Mal Unidas/complicaciones , Síndrome del Dedo del Pie en Martillo/cirugía , Fracturas de la Tibia/complicaciones , Articulación del Dedo del Pie/cirugía , Artrodesis , Contractura/etiología , Deformidades Adquiridas del Pie/diagnóstico por imagen , Deformidades Adquiridas del Pie/etiología , Hallux , Síndrome del Dedo del Pie en Martillo/diagnóstico por imagen , Síndrome del Dedo del Pie en Martillo/etiología , Humanos , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/cirugía , Masculino , Radiografía , Traumatismos de los Tendones/etiología , Traumatismos de los Tendones/cirugía , Tenotomía , Articulación del Dedo del Pie/diagnóstico por imagen , Adulto JovenRESUMEN
Metatarsal fractures can present with a variety of situations. Ranging from the relatively benign, isolated central metatarsal fracture to the crush injury leading to extensive damage of the soft tissue and osseous components, these fractures can cause a significant inconvenience to the patient. With the exception of fifth metatarsal base fractures, little standardization is available for the treatment of metatarsal fractures. Controversy still exists regarding the proper treatment of various patient populations for junctional fifth metatarsal fractures. This article discusses the fractures of the first, central, and fifth metatarsals, as well as the treatment for the same.
Asunto(s)
Fracturas Óseas/cirugía , Metatarso/lesiones , Placas Óseas , Hilos Ortopédicos , Fijación Interna de Fracturas/métodos , Fijación Intramedular de Fracturas/métodos , Curación de Fractura/fisiología , Fracturas Óseas/diagnóstico por imagen , Fracturas Conminutas/diagnóstico por imagen , Fracturas Conminutas/cirugía , Fracturas no Consolidadas/diagnóstico por imagen , Fracturas no Consolidadas/cirugía , Humanos , Fracturas Intraarticulares/diagnóstico por imagen , Fracturas Intraarticulares/cirugía , Metatarso/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Radiografía , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugíaRESUMEN
Pantalar arthrodesis is a demanding procedure that serves a useful purpose for stabilization of the ankle, rearfoot, and midfoot. These fusions should be recognized as salvage procedures in the treatment of unstable and debilitating conditions as a result of severe degenerative joint disease, rheumatoid arthritis, neuropathic joint destruction, and paralytic or flail extremity dysfunction. As with all salvage-type procedures, patient and physician expectations must be the same to afford an acceptable and functional postoperative result.
Asunto(s)
Articulación del Tobillo/cirugía , Artrodesis/métodos , Deformidades del Pie/cirugía , Terapia Recuperativa/métodos , Articulación Talocalcánea/cirugía , Artrodesis/instrumentación , Humanos , Cuidados Posoperatorios , Articulaciones Tarsianas/cirugíaRESUMEN
While Behçet's disease is an uncommon presentation to a podiatric clinical setting, it is nonetheless a fascinating and poorly understood disease as demonstrated by the current and historical research available about the topic. Much debate remains about the disease cause, course and treatment goals. Only through further research into the specific components of this multisystem disease will medicine be more fully able to address the needs of the patient. This discussion should offer the podiatric physician an overview of the disease as well as available treatment options.