Techniques in Foot and Ankle Surgery最新文献

{"title":"Reconstruction of the Anterior Tibialis Tendon Using In-phase Tendon Transfers","authors":"Augusto Roca Fernández, Rajul Gupta, Brian Johnson, Richard M. Smith, Richard T. Laughlin","doi":"10.1097/btf.0000000000000396","DOIUrl":"https://doi.org/10.1097/btf.0000000000000396","url":null,"abstract":"Anterior tibialis tendon ruptures or lacerations are rare conditions that do not have a universally accepted treatment. Previously reported methods have described end-to-end repair, transfer of the extensor hallucis longus, and allograft interposition graft. The purpose of this paper is to describe a technique for reconstruction of the anterior tibialis tendon with a transfer of the medial 2 tendons of the extensor digitorum longus (EDL) to span any gaps or diseased tendon. In addition, the lateral 2 tendons of the EDL are transferred to the peroneus tertius to balance dorsiflexion and prevent overpull on the fourth and fifth toes if the EDL tendons are left in place. Using the EDL to reconstruct the anterior tibialis provides an in-phase tendon transfer resulting in symmetric dorsiflexion at the ankle. In addition, the EDL is a normal muscle with the capacity for hypertrophy, which supplements the muscle power of the injured anterior tibialis which often atrophies in the interim between injury and repair. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional Open Repair and Reconstruction of Achilles Tendon Rupture","authors":"Bonnie Chien, Emily Arciero","doi":"10.1097/btf.0000000000000393","DOIUrl":"https://doi.org/10.1097/btf.0000000000000393","url":null,"abstract":"Despite the development of minimally invasive techniques and more effective nonoperative functional rehabilitation protocols, traditional open approaches remain viable options for both acute and chronic Achilles tendon rupture repair and reconstruction. Here, techniques for open Achilles tendon repair and reconstruction are discussed, along with outcomes, possible complications, and brief comparisons to other management options. Level of Evidence: Level V.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135778538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtalar Distraction Bone Block Arthrodesis for Calcaneus Fracture Malunion","authors":"Deepak Ramanathan, Alexander S. Rascoe, Albert T. Anastasio, Neil K. McGroarty, Jie Chen, Karl M. Schweitzer","doi":"10.1097/btf.0000000000000392","DOIUrl":"https://doi.org/10.1097/btf.0000000000000392","url":null,"abstract":"Intra-articular calcaneus fractures are associated with a high rate of malunion resulting in hindfoot and ankle impingement, peroneal tendinitis, sural neuritis, arthritis, hindfoot varus or valgus deformity, loss of hindfoot height, and resulting gastrocnemius-soleus complex weakness and gait dysfunction. These issues can arise whether the patient’s injury is treated conservatively with non–weight-bearing precautions, neglected/missed, or treated surgically with open reduction and internal fixation. The sequelae of calcaneal malunions can arise early or late in this process. For patients undergoing subtalar arthrodesis following calcaneus fracture malunion, the use of a bone block wedge can assist with achieving a stable ,well-aligned, pain-free hindfoot. Patient selection, preoperative planning, careful surgical technique, and compliance with postoperative care pathways are critical to optimize patient outcomes and healing of this complex reconstruction. Recent evidence supports the utility of weight-bearing CT to assist with preoperative planning for subtalar arthrodesis. Wedges used in subtalar distraction arthrodesis include bulk autograft (tricortical iliac crest), allograft (pre-fashioned or intraoperatively fashioned wedges from femoral head allograft or other source), and metallic wedges. These wedges are typically secured with screws spanning and compressing the arthrodesis site, which is filled with a mixture of concentrated bone marrow aspirate, bone growth factors, and allograft bone. Concomitant procedures may be indicated to ensure the overall success of the procedure, such as extra-articular, calcaneal osteotomy for additional realignment purposes and/or arthrolysis. A review of the literature shows high rates of union following subtalar bone block arthrodesis with improved functional outcomes. Our preferred technique for a bone block distraction subtalar arthrodesis, described herein, includes the use of an allograft wedge. Ongoing advances, such as the development of novel materials and structures for use in subtalar bone block arthrodesis, but most importantly, the incorporation of weight-bearing CT technology and potential for preoperative CT navigation to make this procedure more predictable, are all important areas for further exploration and future research. Level of Evidence: Level—4.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135141326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel All-Inside Knotless Arthroscopic Deltoid Ligament Repair","authors":"Patrick J. Tansey, Isaac Castillo, V. Panchbhavi","doi":"10.1097/btf.0000000000000390","DOIUrl":"https://doi.org/10.1097/btf.0000000000000390","url":null,"abstract":"Injury to the deltoid ligamentous complex is frequently observed in ankle fractures and multidirectional instability. While open deltoid repair has traditionally been performed, arthroscopic repair techniques have also been described. We present a new method to perform a knotless medial ligament complex repair utilizing an all-inside technique and provide short-term outcomes of our clinical series.\u0000 \u0000 Level of Evidence: Level V, expert opinion.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"7 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87923879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DermaClose: A Case Series in the Management of Large Soft Tissue Defects in Diabetic Foot Infection","authors":"Kathryn Brannigan, Susie Zhi Jie Yao, Edward Gee","doi":"10.1097/btf.0000000000000389","DOIUrl":"https://doi.org/10.1097/btf.0000000000000389","url":null,"abstract":"\u0000 \u0000 Diabetic foot infection poses a complex problem due to several interrelated issues, including rapidly spreading infection, poor vascular supply, and reduced healing ability. Management may require multiple operative procedures and prolonged treatment with a high risk of morbidity, such as amputation, and mortality.\u0000 Debridement of infection commonly creates large wounds and soft tissue defects, with limited soft tissue reconstructive options due to adverse local and systemic factors. In this setting, treatment often consists of protracted periods of secondary wound healing by granulation, de-tensioning the tissues by removing bone, and minor or major amputation. Flaps and grafts may be considered but often carry unacceptable rates of failure. We present 3 cases in which DermaClose, an automated wound management system, was employed by a joint Orthopedic and Plastic Surgery team with excellent results and rapid closure of large soft tissue defects.\u0000 \u0000 \u0000 \u0000 Level IV.\u0000","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"33 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81597143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Technique for Lateral Ankle Ligament Reconstruction in a Total Ankle Total Talus Replacement Case","authors":"E. Lukosius, A. Anastasio, Karl M. Schweitzer","doi":"10.1097/BTF.0000000000000384","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000384","url":null,"abstract":"In recent years, the tibial component and polyethylene bearing of a total ankle replacement have been used in conjunction with a custom total talus replacement in cases of severe talar loss with concomitant tibiotalar arthritis, referred to as total ankle total talus replacement. Multiple reports have linked ligamentous instability with poor outcomes after total ankle replacement. In the current study, we describe a surgical technique for lateral ankle ligament reconstruction in a total ankle total talus replacement case through the use of 3-dimensionally printed tunnels. Level of Evidence: Diagnostic Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"23 1","pages":"145 - 154"},"PeriodicalIF":0.3,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61625339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mini Bone Extra-articular Reconstruction System for Progressive Collapsing Foot Deformity—Surgical Technique With Cadaveric Quantification of Surrounding Anatomy","authors":"Derrick E. Wendler, Ademola Shofoluwe, G. Stewart, E. Bailey","doi":"10.1097/btf.0000000000000382","DOIUrl":"https://doi.org/10.1097/btf.0000000000000382","url":null,"abstract":"\u0000 \u0000 We present a novel surgical technique, the mini Bone Extra-articular Reconstruction (BEAR) system, that involves minimally invasive all BEAR systems. The surgical technique was used to perform the medial displacement calcaneal osteotomy, Evans osteotomy, and Cotton osteotomy on 9 cadaveric feet under fluoroscopic guidance. We also present a case series of patients who have undergone the procedure. We first carefully dissected the sural nerve, superficial peroneal nerve, and its branches from each cadaveric foot and evaluated injuries following the mini-BEAR osteotomy cuts. We then measured and recorded the distance between the osteotomy cuts and these anatomic structures. We believe that this technique can potentially replace the multiple long surgical incisions with minimal ones.\u0000 \u0000 \u0000 \u0000 Level IV.\u0000","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"139 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73255827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achilles Tendon Ruptures: Anatomy and Physiology","authors":"J. Greisberg, Emily Arciero","doi":"10.1097/btf.0000000000000388","DOIUrl":"https://doi.org/10.1097/btf.0000000000000388","url":null,"abstract":"Together, the muscle bellies of the medial and lateral gastrocnemius along with the soleus conjoin to make the Achilles tendon. The Achilles tendon is the most commonly ruptured tendon. It is important to take into account the length-tension relationship of muscle and anatomic positioning of the Achilles when treating Achilles tendon ruptures.\u0000 \u0000 Level of Evidence: Level V, expert opinion.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"12 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91256706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of Achilles Tendon Skin Defect Using Single-Stage Reverse Sural Artery Island Flap","authors":"Gaurav Patodia","doi":"10.1097/btf.0000000000000387","DOIUrl":"https://doi.org/10.1097/btf.0000000000000387","url":null,"abstract":"Wound complications following open repair of a ruptured Achilles tendon are common and require immediate skin cover. This study analyses the use of a reverse sural artery island flap to cover skin defects over an exposed intact Achilles tendon. Thirteen patients with postoperative wound complications over the tendoachilles were operated upon. All wounds were debrided and reconstructed with a single-stage reverse sural artery island flap. Within 5 weeks of flap cover, 12 wounds healed completely, while 1 flap had superficial necrosis at the margin in a diabetic patient. This eventually healed and did not compromise the final result. None of the flaps had venous congestion. In our hands, reconstructing skin defects following wound complications after Achilles tendon repair with islanded reverse sural artery flap is a reliable and safe option.\u0000 \u0000 Level of Evidence: Level IV.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82906742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonoperative Management of Achilles Tendon Ruptures","authors":"B. King, Erickson G Andrews","doi":"10.1097/btf.0000000000000383","DOIUrl":"https://doi.org/10.1097/btf.0000000000000383","url":null,"abstract":"\u0000 \u0000 Acute Achilles tendon ruptures are an increasingly common injury. Although operative fixation continues to be dominant in the United States, a growing body of literature supports nonoperative management. Although the specifics of functional rehabilitation vary, many studies support this management approach. Continued controversies include the type of castor orthosis used, acceptable gap size, need for ultrasound evaluation, time to initiation of weight bearing, time to initiation of motion, duration of orthosis, length of treatment, and use of heel wedges in shoes once the orthosis is discontinued.\u0000 \u0000 \u0000 \u0000 Level I.\u0000","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"140 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75640130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}