Foot and ankle clinics
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The treatment of calcaneus fractures is controversial. Historically, most operatively treated fractures have been approached with a lateral extensile incision requiring delay in operative treatment until swelling has improved. ⋯ Clinical scenarios amenable to consideration for early fixation are reviewed. The sinus tarsi surgical approach and reduction techniques are outlined in detail.
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Foot and ankle clinics · Mar 2017
Review Comparative StudyOpen Reduction and Internal Fixation Versus Primary Arthrodesis for Lisfranc Injuries.
Management of injuries to the tarsometatarsal (Lisfranc) joint complex continues to generate heated debate. Arthrodesis of the Lisfranc joint complex has historically been reserved as a salvage procedure for failed treatment. Recently, primary arthrodesis has emerged as a viable treatment alternative to open reduction and internal fixation for these injuries. The objective of this article was to examine the current literature regarding open reduction and internal fixation versus primary arthrodesis of Lisfranc injuries.
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Chopart joint injuries have a profound effect on global foot function. Surgical treatment aims at joint reconstruction and axial alignment with restoration of the normal relationship of the lateral and medial foot columns. ⋯ Primary fusion sacrifices essential joints and should be reserved for severe initial cartilage damage. Corrective fusion becomes necessary for malunited Chopart joint injuries with rapidly evolving posttraumatic arthritis.
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Foot and ankle clinics · Mar 2017
ReviewPosterior Malleolar Fractures: Changing Concepts and Recent Developments.
Injuries to the posterior malleolus are of prognostic relevance in ankle fracture-dislocations. The three-dimensional outline of the fragments as reflected by computed tomography classification, involvement of the fibular notch, and the presence of intercalary fragments seem to be of greater therapeutic relevance than the size of the fragment and amount of the articular surface involved. Operative treatment aims at reconstruction of the posterior tibial plafond, the fibular notch, and the integrity of the posterior inferior tibiofibular syndesmosis. Direct open reduction and fixation of posterior malleolus fragments via posterior approaches is biomechanically more stable than indirect reduction and anteroposterior screw fixation.
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Foot and ankle clinics · Sep 2016
ReviewEndoscopic Ankle Lateral Ligament Graft Anatomic Reconstruction.
Chronic instability is a common complication of lateral ankle sprains. If nonoperative treatment fails, a surgical repair or reconstruction may be indicated. ⋯ The endoscopic technique is reproducible and safe with regard to the surrounding anatomic structures. Short and midterm results confirm the benefits of this technique.