Foot & ankle international
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Nonunion of classic Jones fractures has typically been attributed to the precarious vascular anatomy of the proximal fifth metatarsal. Despite this theory, the operative treatment of these fractures utilizes biomechanical solutions. The purpose of the present study was to evaluate the influence of the peroneus brevis (PB) tendon on the stability of fractures of the proximal fifth metatarsal. ⋯ Our findings help support the notion that a mechanical component may contribute to the poor healing potential of Jones fractures secondary to deformation exerted by the PB tendon.
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Liposomal bupivacaine is increasingly being utilized in attempts to provide prolonged local analgesia in the immediate postoperative period. The purpose of this study was to quantify the reduction in opioid consumption as well as postoperative pain scores in the postoperative period when liposomal bupivacaine is used at the conclusion of forefoot surgery. ⋯ Level II, prospective comparative study.
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The aim of this study was to quantify the incidence of postoperative wound complications in elective foot and ankle surgery as well as the risk factors for postoperative wound complications. ⋯ Prognostic Level III, comparative study.
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The flexor to extensor transfer of the flexor digitorum longus (FDL) tendon has been a relatively common operative procedure for the treatment of a flexible hammer toe deformity and chronic metatarsophalangeal (MTP) joint dislocation. A possible complication of using the tunnel technique rather than the tendon splitting technique is iatrogenic fracture through the drilled tunnel site. The purpose of this investigation was to study the FDL tendon and proximal phalanx dimensions in the area of the transfer procedure in order to improve preoperative planning and minimize postoperative complications. Additionally, this study investigated the force necessary to create a fracture in a predrilled proximal phalanx and attempted to elucidate a relationship between that force and the percentage of bone remaining after the drilling process. ⋯ Iatrogenic fracture may occur in proximal phalanges with a diameter of bone less than 6 mm, as there may not be adequate bone strength remaining to withstand postoperative forces.
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Kirschner wire (K-wire) fixation for correction of hammertoe deformity is a common, low-cost method for fixation of hammertoes after proximal interphalangeal (PIP) arthroplasty or fusion. Complications of this procedure include pin-tract infection, pin migration, pin bending or breakage, and recurrence of deformity. The investigators reviewed a large experience using K-wire stabilization for hammertoe correction. ⋯ Level IV, retrospective case series.