Foot and ankle clinics
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Foot and ankle clinics · Mar 2016
ReviewJoint-Sparing Corrections of Malunited Chopart Joint Injuries.
Treatment of malunion and nonunion at the Chopart joint aims at axial realignment of the midfoot to the hindfoot and restoration of the normal relationship of the lateral and medial columns of the foot. In carefully selected patients with intact cartilage, joint-preserving osteotomies are feasible at all 4 bony components of the Chopart joint to restore near-normal function. Priority should be given to the anatomic reconstruction of the talonavicular joint because it is essential for global foot function. Patients must be counseled about the risk of progressive arthritis or osteonecrosis necessitating late fusion.
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Foot and ankle clinics · Mar 2016
ReviewCorrective Osteotomies for Malunited Extra-Articular Calcaneal Fractures.
The most effective way to treat calcaneal malunions is avoidance. With any articular fracture, progressive arthrosis and dysfunction are common. ⋯ In patients with no or minimal articular degeneration, extrarticular joint-sparing procedures can be performed. This represents a small select group who may benefit from simple osteotomy procedures with associated soft tissue reconstruction, if needed.
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Foot and ankle clinics · Mar 2016
ReviewJoint-sparing Corrections in Malunited Lisfranc Joint Injuries.
Lisfranc fracture-dislocations are very serious and potentially disabling injuries. Unfortunately, they are often misdiagnosed. ⋯ Anatomic reduction with different types of internal fixation is an efficient method to reconstruct midfoot alignment and stability. Joint-preserving reconstruction techniques emerge as a viable alternative to corrective fusion as they achieve stable joint realignment with preserved motion.
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Foot and ankle clinics · Dec 2015
ReviewPediatric Ankle Fractures: Concepts and Treatment Principles.
Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation, and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate examination, imaging, and knowledge of fracture patterns specific to children. ⋯ Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high-risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity.
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Metatarsal fractures are those most frequently encountered in the foot. More than half of these are of the 5th metatarsal. ⋯ Distal fractures rarely require fixation, even when displacement is wide. Cases of established nonunion or refracture require fixation.