Johnson and Strom (1989) recommended subtalar fusion for correction of the acquired flatfoot when the deformity of the foot was fixed (stage 3). This was based on the concept that the midfoot and forefoot would follow the calcaneum â€“ the "two-piece concept".
As the commonest deformity of adult acquired flatfoot is...
Excision, or amputation, of a toe refers to the surgical removal of a toe or a portion of a toe (e.g., distal phalanx). Fusion (arthrodesis) of a toe refers to the permanent fusing and immobilization of a joint or joints in a toe. Repair of a toe refers to the...
Fusion of the first MTP joint in a corrected position will correct deformity. The intermetatarsal angle usually reduces in the months after surgery as the pressure of the phalanx against the metatarsal head is reduced; a first metatarsal osteotomy is not usually necessary.
The Lapidus procedure is a corrective fusion of the 1st TMT joint with a distal soft-tissue correction. It is designed to stabilise a hypermobile first ray. It can also be useful when a severe deformity is associated with 1st TMT OA or an adult acquired flatfoot deformity.
Like a proximal osteotomy,...
Correction of a fixed flexion deformity of the PIP joint requires:
* excision of enough bone to reduce the deformity
* stabilisation to allow healing
Either a simple excision arthroplasty, removing the condyles of the proximal phalanx, or a fusion with bone removed from both sides of the joint, can achieve...
Triple arthrodesis is considered as a late salvage-stabilising procedure that relieves pain but sacrifices joint motion. If the subtalar or midtarsal joints are arthritic and painful, a triple arthrodesis will allow correction and pain control. The trend for triple fusion in the younger HMSN has fallen out of favour of late.
A triple arthrodesis consists of the surgical fusion of the talocalcaneal (TC), talonavicular (TN), and calcaneocuboid (CC) joints in the foot. The primary goals of a triple arthrodesis are to relieve pain from arthritic, deformed, or unstable joints. Other important goals are the correction of deformity and creation of a...
Wedge resection of talus to correct fixed equinus deformity
60% had residual deformity
25% Significant pain
38% Degenerative changes in ankle
May need elongation of tendo Achilles & soft tissue release before able to obtain correction.
This may decrease resection required & incidence of AVN of talus.
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