دسترسی نامحدود
برای کاربرانی که ثبت نام کرده اند
دانلود کتاب Coughlin and Mann's Surgery of the foot and ankle
دانلود کتاب جراحی Coughlin و Mann از پا و مچ پا
مشخصات کتاب
Coughlin and Mann's Surgery of the foot and ankle
ویرایش: [10 ed.] نویسندگان: Haskell. Andrew. author., Coughlin. Michael J.. author., Haskell. Andrew. editor سری: ISBN (شابک) : 9780323833844 ناشر: Elsevier سال نشر: 2024 تعداد صفحات: 2200 [2130] زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 1 Gb
قیمت کتاب (تومان) : 87,000
در صورت تبدیل فایل کتاب Coughlin and Mann's Surgery of the foot and ankle به فرمت های PDF، EPUB، AZW3، MOBI و یا DJVU می توانید به پشتیبان اطلاع دهید تا فایل مورد نظر را تبدیل نمایند.
توجه داشته باشید کتاب جراحی Coughlin و Mann از پا و مچ پا نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
توضیحاتی درمورد کتاب به خارجی
فهرست مطالب
Cover Any screen, Any time, Anywhere Any screen. Any time. Anywhere. Title page COUGHLIN AND MANN’S Surgery of the Foot and Ankle Copyright Copyright Dedication Dedication Contributors Contributors Preface Preface Acknowledgments Acknowledgments Acknowledgment of Previous Editions ACKNOWLEDGMENT OF PREVIOUS EDITIONS In Appreciation In Appreciation Contents Contents Video Table of Contents Video Table of Contents PART I. General Considerations 1. Biomechanics of the Foot and Ankle 1 Biomechanics of the Foot and Ankle Gait Cycle Foot And Ankle Biomechanics Joint Mechanics The Ankle Joint The Subtalar Joint The Transverse Tarsal Joint Complex Tarsometatarsal Joints and Columns of the Midfoot Metatarsophalangeal Joints Progression From a Supple to Rigid Platform Passive and Active Modulators of Joint Biomechanics The Plantar Aponeurosis The Posterior Calf Muscles The Anterior Calf Muscles Ligaments of the Ankle Putting It Together: Joint Mechanics and Modulators During Gait First Interval Second Interval Third Interval Component Mechanics of Running Clinical Implications Of Foot And Ankle Biomechanics Ankle Arthrodesis Transverse Rotation Varus or Valgus Tilt Dorsiflexion Hindfoot Alignment Midfoot Alignment Forefoot Principles Tendon Transfers Ankle Ligaments Kinematics And Kinetics Of Human Locomotion Kinematics Vertical Body Displacements Lateral Body Displacements Horizontal Limb Rotation Kinetics Measuring Whole Body Kinetics and Plantar Pressure Types of studies. Data representations. Measurement variability. Kinetics of Walking Plantar pressure kinetics. Whole body kinetics. Kinetics of Running References 2. Principles of the Physical Examination of the Foot and Ankle 2 Principles of the Physical Examination of the Foot and Ankle Overview Sequence Of Examination Topographic Anatomy Ankle and Hindfoot Lateral Ankle Medial Ankle Posterior Ankle Anterior Ankle Plantar Hindfoot Midfoot Forefoot Hallux Complex Lesser Metatarsals and Toes Examination In Sequence Standing Examination Sitting Examination General Visual Overview General Skeletal Overview Neurovascular Examination Range of Motion of the Joints Ankle joint. Subtalar joint. Transverse tarsal joint. Tarsometatarsal joints. Metatarsophalangeal joints. Relationship of Forefoot to Hindfoot Direct Palpation Muscle Function Specific Examination Components for Individual Consideration Supine Examination Prone Examination Gait Shoe Examination References 3. Imaging of the Foot and Ankle 3 Imaging of the Foot and Ankle Role Of Imaging Effective Use of Imaging Choice of Test Radiation Safety Radiographs Eos Ultrasound Basic Science Use of Ultrasound Nuclear Medicine Basic Science Technetium-99m–Methylene Diphosphonate Bone Scanning Single-Photon Emission Computed Tomography Gallium Scanning and White Cell Scanning Use of Nuclear Scanning Computed Tomography Basic Science Use of Computed Tomography Scanning Dual Energy CT Weight-Bearing CT Magnetic Resonance Imaging Basic Science Magnetic Resonance Imaging Clinical Sequences T1-Weighted Fast Spin-Echo Sequences T2-Weighted Fast Spin-Echo Sequences Proton-Density–Weighted Fast Spin-Echo Sequences Short Tau Inversion Recovery or “Fat-Sat” Sequences Gradient-Recalled Echo Sequences Magnetic Resonance Arthrography MRI Neurography New Magnetic Resonance Imaging Technique: Biochemical Imaging T2 Mapping Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage T1 Rho (ρ) Mapping Contraindications to Magnetic Resonance Imaging Pitfalls and Artifacts in Magnetic Resonance Imaging Magic Angle Phenomenon Bone Marrow “Edema” Use of Magnetic Resonance Imaging Imaging Of Foot And Ankle Pathology Imaging Ligament Injury Ankle and Transverse Tarsal Joint Ligament Complex Injury Midfoot Ligamentous Injury Forefoot Ligament Injury Imaging Chondral and Osteochondral Lesions Imaging Articular Cartilage Repair Imaging Impingement Syndromes Imaging Tendon Pathology Tendinosis Stenosing Tenosynovitis Tendon Tears Imaging Inflammatory Arthropathies Imaging Nerve Pathology in the Foot and Ankle Imaging Tumors in the Foot and Ankle Imaging Infections in the Foot and Ankle Miscellaneous Conditions in the Foot and Ankle Complex Regional Pain Syndrome Arthrofibrosis Posttraumatic Fat Necrosis Foreign Bodies Avascular Necrosis of Bone in the Foot and Ankle Interventional Radiology In The Foot And Ankle References 4. Scientific Evidence-Based Foot and Ankle Care 4 Scientific Evidence-Based Foot and Ankle Care What is scientific evidence-based medicine? How to practice scientific evidence-based medicine Ask a Clinical Question Acquire the Relevant Published Literature That Addresses the Clinical Question Assess the Quality of Each Relevant Publication Assembled Using Scientific Methodologies Summarize the Literature to Provide a Consensus and Treatment Recommendation Rate Your Performance The importance of evidence-based care The future of evidence-based care Summary References 5. Nonsurgical Treatment of Foot and Ankle Conditions 5 Nonsurgical Treatment of Foot and Ankle Conditions General Considerations Foot Orthoses Over-the-Counter Inserts Custom Foot Orthoses University of California Biomechanics Laboratory Foot Orthoses Ankle–Foot Orthoses Posterior Leaf Spring Ankle Foot Orthosis Articulated Ankle Foot Orthosis Solid-Ankle Ankle Foot Orthoses Arizona-Type Ankle Foot Orthosis Charcot Restraint Orthotic Walker Solid Ankle Dynamic Ankle Foot Orthosis Design Considerations Appliances Injections and Other Adjuvant Treatments Hyaluronic Acid Platelet-Rich Plasma Extracorporeal Shock Wave Therapy Treatment of Specific Disorders Arthritis Tendon Disorders Heel Pain Lesser TOE Disorders Calluses and Corns Neuromas Bunionettes First Metatarsophalangeal Joint Hallux Valgus Deformities Hallux Rigidus Sesamoid Disorders Shoe Anatomy References 6. Regional Anesthesia for the Foot and Ankle 6 Regional Anesthesia for the Foot and Ankle OVERVIEW NEURAL ANATOMY OF THE FOOT AND ANKLE Sensory Innervation REGIONAL ANESTHESIA Ultrasound-Guided Peripheral Nerve Blocks Types of Nerve Blocks Continuous Peripheral Nerve Block Nerve Blocks Above the Knee Sciatic Nerve Block at the Popliteal Fossa Continuous Popliteal Sciatic Nerve Block Saphenous Nerve Block Above the Knee Nerve Blocks Below the Knee The Saphenous Nerve The Tibial Nerve The Superficial Peroneal Nerve The Deep Peroneal Nerve The Sural Nerve Digital Nerves NERVE BLOCK COMPLICATIONS Nerve Injury Intravascular Injection of Local Anesthetic Infection A CHANGING ROLE FOR OPIOIDS MULTIMODAL ANESTHESIA COMPONENTS OF MULTIMODAL ANESTHESIA Nonsteroidal Antiinflammatory Drugs Acetaminophen and Paracetamol Combining Acetaminophen and Nonsteroidal Antiinflammatory Drugs Pregabalin and Gabapentin Opioid Agonists Combined Opioid Agonist–Monoamine Reuptake Inhibitors Glucocorticoids PATIENTS WHO REQUIRE SPECIAL CONSIDERATION Patients With Obstructive Sleep Apnea Chronic Opioid-Consuming Patients SUMMARY Acknowledgments References PART II. Forefoot and Heel 7. Hallux Valgus 7 Hallux Valgus Anatomy Blood Supply to the First Metatarsal Head Pathoanatomy Pathophysiology Demographics Prevalence of Bunions Age of Onset Gender Bilaterality Etiology Extrinsic Causes Footwear Occupation Trauma Intrinsic Causes Heredity and Genetics Pes Planus Hypermobility of the Metatarsocuneiform Joint Ligamentous Laxity Achilles Contracture Other Factors Radiographic Measures Angular Measurements Hallux Valgus Angle 1–2 Intermetatarsal Angle Hallux Interphalangeal Angle Distal Metatarsal Articular Angle Metatarsophalangeal Joint Congruency Medial Eminence Metatarsus Primus Varus Hallux Valgus Interphalangeus First Metatarsal Length Metatarsophalangeal Joint Shape Joint Congruity Distal Metatarsal Articular Angle First Metatarsocuneiform Joint Intermetatarsal Facet/Os Intermetatarseum Metatarsus Adductus Role of Weight-Bearing CT Scan Juvenile Bunions Open Physes Juvenile Hallux Valgus Classification of Hallux Valgus Deformities Patient Evaluation Conservative Treatment Perioperative Considerations Anesthesia and Pain Control Factors Impacting Outcomes Surgical Decision Making Surgical Treatment Algorithm Incongruent Congruent Arthrosis Surgical Procedures Distal Procedures Distal Soft Tissue Procedure (Video 7-1) Indications Contraindications Surgical technique Release of the first web space Recurrence of deformity. Arthrofibrosis. Peripheral nerve entrapment. Hallux varus. Intermetatarsal (interosseous) fixation. Postoperative care Results Complications Akin Procedure (Videos 7-2 and 7-3) Indications Contraindications Surgical technique—open Akin Surgical technique—minimally invasive Akin Postoperative care Results Complications Distal Metatarsal Osteotomy (Chevron Procedure) (Videos 7-4 and 7-5) Indications Contraindications Surgical technique Medial Approach and Exposure of the Metatarsal Head Postoperative care Results Complications Distal Metatarsal Osteotomy (Mitchell, Bosch Types) Indications Surgical technique Surgical Approach Surgical technique of Bosch (percutaneous osteotomy) Postoperative care Results Complications Midshaft Osteotomies Scarf Osteotomy (Video 7-6) Indications Surgical technique Surgical Approach Postoperative care Key points in the technique Results Complications Proximal Osteotomies Proximal Crescentic Osteotomy (Video 7-7) Indications Contraindications Surgical technique. Proximal Oblique Metatarsal Osteotomy Surgical technique. Long Oblique Osteotomy (Mau, Ludloff) Surgical technique. Reconstruction of Hallux Valgus Deformity After Any Proximal Osteotomy Surgical technique. Postoperative care Results Complications Multiple Osteotomies (Video 7-8) Medial Cuneiform Osteotomy Surgical technique. Postoperative care Distal First Metatarsal Closing-Wedge (Reverdin) Osteotomy Surgical technique. Other osteotomies Results Complications Arthrodesis Procedures Lapidus Procedure (Video 7-9) Indications Contraindication Surgical technique Postoperative care Results Complications Metatarsophalangeal Joint Arthrodesis Indications Surgical technique Alternative method of fixation. Postoperative care Results Complications Keller Procedure (Video 7-10) Indications Surgical Technique Postoperative Care Results Complications Complications of Hallux Valgus Surgery Conclusions References 8. Hallux Varus and Complications of Bunion Repair 8 Hallux Varus and Complications of Bunion Repair Soft Tissue Complications Infection Superficial Infection Deep Infection Delayed Wound Healing Skin Slough Adherent Scar Paresthesias of the Hallux Delayed Wound Breakdown Hallux Varus Following Bunion Correction Treating Hallux Varus Extensor Hallucis Longus Transfer (Video 8-1) Surgical technique. Surgical approach and preparation for tendon transfer Medial joint capsule release Reconstruction of the metatarsophalangeal joint Alternative procedures. Postoperative care. Results. Unexpected Outcomes Following Hallux Valgus Surgery Causes of Surgical Failure Procedure Selection Postoperative Management and Compliance Planning Ahead Common Complications Following Bunion Surgery Pain Around the First Metatarsophalangeal Joint Complications Affecting the Metatarsal Shaft Shortening Dorsiflexion Plantar Flexion Excessive Valgus (Lateral Deviation) of the First Metatarsal Nonunion of the First Metatarsal Complications Affecting the Metatarsal Head Excessive Excision Displacement Avascular Necrosis Complications Involving the Proximal Phalanx Nonunion Malunion Avascular Necrosis Adhesions of the Flexor Hallucis Longus Violation of the Metatarsophalangeal Joint Instability After Resection of the Base (Keller Procedure) Complications Associated With Capsular Tissue of the First Metatarsophalangeal Joint Failure of Medial Joint Capsular Tissue Failure of Lateral Joint Capsular Tissue Arthrofibrosis of the Metatarsophalangeal Joint Complications Involving the Sesamoids Uncorrected Sesamoids Medial Subluxation or Dislocation of the Tibial Sesamoid Cock-Up Deformity of the First Metatarsophalangeal Joint Intractable Plantar Keratosis Recurrent Hallux Valgus Deformity Preoperative Conditions Conditions Particular to a Procedure Distal Soft Tissue Procedure Chevron Procedure Proximal Metatarsal Osteotomy Akin Procedure Scarf Procedure Keller Procedure Conclusions References 9. Lesser Toe Deformities 9 Lesser Toe Deformities Lesser Toe Deformities Overview Anatomy and Pathophysiology Extensor Digitorum Longus Muscle and Tendon Interosseous Tendons Plantar Plate and Collateral Ligaments Pathophysiology Etiology and Presenting Symptoms Mallet Toe Hammer Toe Claw Toe Preoperative Evaluation Physical Examination Radiographic Examination Fixed Hammer Toe Deformity Preoperative Planning Surgical Considerations DuVries Arthroplasty Procedure (PIP Joint Resection Arthroplasty) (Video 9-1) Surgical technique The technique is as follows. Alternative fixation and joint preparation Hammer Toe Repair with Intermedullary Implant (PIP Joint Arthrodesis) (Video 9-2) Surgical technique Postoperative care Results of Hammer Toe Repair Condylectomy and Fusion Less Common Procedures Complications Flexible Hammer Toe Deformity Preoperative Planning Surgical Considerations Flexor Tendon Transfer Procedure43,48 (Video 9-3) Surgical technique Alternative technique Postoperative care Results and Complications Curly Toe Deformity Mallet Toe Deformity38,45 Preoperative Planning Surgical Considerations Mallet Toe Repair42,45,48 (Video 9-4) Surgical technique Alternative fixation Postoperative care Results and Complications Claw Toe Deformities Preoperative Planning Surgical Considerations PIP Joint Contracture Correction Claw Toe Contracture Release Surgical technique Hallux Interphalangeal Joint Arthrodesis (see Video 27-6) Surgical technique Postoperative care Results and Complications Subluxation And Dislocation Of The Lesser Metatarsophalangeal Joint Anatomy of Lesser Metatarsophalangeal Joint Subluxation Etiology History and Demographics Preoperative Evaluation Physical Examination Radiographic Examination Treatment Conservative Treatment Preoperative Planning Soft Tissue Release Surgical technique Postoperative care Reefing of the Second Metatarsophalangeal Joint Capsule159 Surgical technique Extensor Digitorum Brevis Transfer106,131 Surgical technique Postoperative care Plantar Condylectomy (see Video 13-1) Surgical technique Postoperative care Phalangeal Closing Wedge Osteotomy (“Akinette”)63,137,214 Surgical technique Postoperative care Capital Oblique Metatarsal Osteotomy (Weil Osteotomy)104,253 (Video 9-5) Indications Contraindications Surgical technique Postoperative care Plantar Plate Repair51,56,184 (Video 9-6) Surgical technique Postoperative care Results Complications Ischemic Toe Salvage Procedures Surgical Considerations DuVries Metatarsophalangeal Joint Arthroplasty Surgical Technique182 Postoperative care Partial Proximal Phalangectomy and Syndactylization61,81 Surgical Technique Alternative Method Postoperative Care Results and Complications Fifth Toe Deformities Anatomy Physical Examination Conservative Treatment Mild Overlapping Fifth Toe Deformities DuVries Fifth Toe Realignment Surgical technique Postoperative care Severe Overlapping Fifth Toe Deformities Wilson Fifth Toe Procedure258 Surgical technique Postoperative care Lapidus Procedure150 (Video 9-7) Surgical technique Postoperative care Results of Overlapping Fifth Toe Procedures Underlapping Fifth Toe Thompson Repair239 Surgical technique Postoperative care Results and complications Cock-Up Fifth Toe Deformity Ruiz-Mora Procedure73,123,213 Surgical technique Postoperative care Results and complications Syndactylization of the Lesser Toes Surgical technique Postoperative Care Alternative procedure Results and complications Keratotic Deformities Of Lesser Toes Etiology Preoperative Evaluation Physical Examination Radiographic Evaluation Treatment Conservative Treatment Surgical Treatment of Lateral Fifth Toe Corns (Video 9-8) Surgical technique Postoperative care Treatment of Interdigital Corns (Video 9-9) Surgical technique Postoperative care Results and Complications References 10. Bunionettes 10 Bunionettes ANATOMY CLINICAL SYMPTOMS PHYSICAL EXAMINATION DIAGNOSTIC AND RADIOGRAPHIC EXAMINATION CONSERVATIVE TREATMENT Author’s Preferred Method of Treatment SURGICAL TREATMENT Preoperative Evaluation Preoperative Planning Surgical Techniques Lateral Condylectomy Indications. Contraindications. Surgical technique. Postoperative care. Results and complications. Fifth Metatarsal Head Resection Indications. Contraindications. Surgical technique. Postoperative care. Results and complications. Distal Fifth Metatarsal Osteotomies (Videos 10-1 to 10-4) Throckmorton and bradlee9 and others23,40,45,52 described a distal fifth metatarsal transverse chevron osteotomy. Because o ... Contraindications. Distal Transverse Medializing Osteotomy with Steinmann Pin Fixation14,78,51 Surgical technique. Postoperative care. Results and complications. Distal Chevron Osteotomy (Videos 10-1 and 10-2). Surgical technique. Postoperative care. Results and complications. Distal Oblique Osteotomy (Video 10-3) Surgical technique. Postoperative care. Capital Oblique Osteotomy (Modified weil) (Author's Preferred Technique) (Video 10-4) Surgical technique. Postoperative care. Results and complications. Midshaft Scarf Osteotomy 35,43,46 Indications. Contraindications. Surgical technique (Fig. 10-32). Postoperative care. Results and complications. Midshaft (Diaphyseal) Osteotomies (Video 10-5) Indications. Contraindications. Midshaft Oblique Osteotomy (Author's Preferred Technique) (Video 10-5) Variation. Postoperative care. Results and complications. Proximal Fifth Metatarsal Osteotomy Indications. Contraindications. Surgical technique. Postoperative care. Results and complications. Minimally Invasive Surgery for Bunionette Correction Indications. Contraindications. Surgical technique61,65,66. 8.A gauze dressing is applied to help maintain the correction Postoperative care. Author's preferred method of treatment References 11. Sesamoids and Accessory Bones of the Foot 11 Sesamoids and Accessory Bones of the Foot Sesamoids Of The First Metatarsophalangeal Joint Anatomy Location, Function, and Size Ossification Circulation Sesamoid Pathology Bipartite Sesamoids and Fractures Treatment. Congenital Absence of the Sesamoids Distorted or Hypertrophied Sesamoids Intractable Plantar Keratoses Bursitis Nerve Compression Arthritis Treatment. Subluxation and Dislocation of the Sesamoids Treatment. Infection Osteonecrosis of the Sesamoids Treatment. Sesamoiditis Clinical Evaluation Physical Examination Radiographic Examination Conservative Treatment Surgical Decision Making for Excision of a Sesamoid Shaving a Prominent Tibial Sesamoid225 Surgical Technique (Video 11-1) Postoperative Results Excision of the Tibial Sesamoid Surgical Technique (Video 11-2) Excision of the Fibular Sesamoid Surgical Technique: Dorsal Approach Surgical Technique: Plantar Approach Postoperative Results of Sesamoid Excision INTERPHALANGEAL SESAMOID OF THE HALLUX Treatment Surgical Technique: Excision of a Subhallux Sesamoid Results ACCESSORY BONES OF THE FOOT Accessory Navicular Anatomy and Incidence Evaluation and Treatment Surgical Technique: Kidner Procedure Results Os Trigonum Anatomy and Incidence Clinical Significance Conservative Treatment Surgical Removal of Os Trigonum Surgical technique: open lateral approach. Surgical technique: endoscopic approach. Results Os Peroneum Clinical Significance Surgical Technique: Excision of the Os Peroneum and Tenodesis of the Peroneus Longus Uncommon Accessory Bones Sesamoid of the Tibialis Anterior Tendon Sesamoid of the Tibialis Posterior Tendon Anatomy and incidence. Clinical significance. Os Subtibiale Anatomy and incidence. Clinical significance. Os Subfibulare Anatomy and incidence. Clinical significance. Os Calcaneus Secundarius Anatomy and incidence. Clinical significance. Calcaneus Accessorius Os Sustentaculi Os Subcalcis and Os Aponeurosis Plantaris Os Cuboides Secundarium Os Talonaviculare Dorsale, Os Supratalare Bipartite Navicular Os Intercuneiform Os Cuneo-I Metatarsale-I Plantare, Os Cuneo-I Metatarsale-II Dorsale Bipartite First Cuneiform Metatarsocuneiform Coalition Os Intermetatarseum Anatomy and incidence. Clinical significance. Os Vesalianum Anatomy and incidence. Clinical significance. References 12. Plantar Heel Pain 12 Plantar Heel Pain History Epidemiology Anatomy Plantar Fascia Heel Fat Pad Etiology Patient History And Physical Examination Detailed History Physical Examination Imaging And Other Diagnostic Studies Nonoperative Treatment Proximal Plantar Fasciitis Stretching Orthotics Casting/Immobilization Antiinflammatories Injections Corticosteroids. Biologics. Botulinum toxin type A. Extracorporeal Shock Wave Therapy Heel Fat Pad Atrophy Treatment Rheumatologic Heel Pain Treatment Neurologic Heel Pain Treatment Authors’ Preferred Nonoperative Treatment for Proximal Plantar Fasciitis First Follow-Up Visit The Patient With Persistent Symptoms Operative Treatment Open Plantar Fascia Release With Tarsal Tunnel Release (Video 12-1) Endoscopic Plantar Fascia Release Gastrocnemius Recession Other Procedures Authors’ Preferred Method of Operative Treatment Younger Patient With Plantar Fasciitis and Associated Neurogenic Signs and Symptoms Open medial one third plantar fascia release with release of tarsal tunnel and first branch of the lateral plantar nerve (V ... Surgical technique. Postoperative protocol. Gastrocnemius recession (Strayer) (Video 37-9). Surgical technique. Postoperative protocol. References PART III. Integument 13. Keratotic Disorders of the Plantar Skin 13 Keratotic Disorders of the Plantar Skin Plantar Keratoses Anatomy Diagnosis Treatment Conservative Treatment Surgical Treatment: Types of Plantar Callosities Localized Intractable Plantar Keratosis DuVries Metatarsal Condylectomy (Video 13-1) Surgical technique. Postoperative care. Results. Coughlin Modified Metatarsal Condylectomy Vertical Chevron Procedure Surgical technique. Postoperative care. Results. Rotational Flap Discrete Callus Beneath Tibial Sesamoid Tibial Sesamoid Shaving Surgical technique. Postoperative care. Results. Diffuse Intractable Plantar Keratosis Distal Metatarsal Osteotomy (Weil Osteotomy) Surgical technique. Results. Oblique Metatarsal Osteotomy Surgical technique. Postoperative care. Results. Basal Metatarsal Osteotomy Surgical technique. Postoperative care. Dorsiflexion Osteotomy of First Metatarsal for Plantar-Flexed First Metatarsal Other Metatarsal Osteotomies Miscellaneous Conditions Subhallux Sesamoid Conservative Treatment Removal of Subhallux Sesamoid Surgical technique. Postoperative Care. Results Osteochondrosis of a Metatarsal Head (Freiberg Infraction) Diagnosis Treatment Decisions Excision of Proliferative Bone (Video 27-7) Surgical technique. Postoperative care. Results. Dorsal Closing Wedge Metatarsal Osteotomy (DCWMO) Surgical technique. Postoperative care. Results. Osteochondral Autograft Transfer (OAT) Surgical technique. Postoperative care. Results. Interpositional Arthroplasty (Figs. 13-45 and 13-46) Surgical technique. Postoperative care. Results. Intractable Plantar Callus Associated With Significant Scar Tissue Formation Scar Excision Surgical technique. Postoperative care. Results. Surgical Scars on the Plantar Aspect of the Foot Acknowledgment References 14. Toenail Abnormalities 14 Toenail Abnormalities Anatomy And Classification Dermatologic And Systemic Nail Disorders Psoriasis Eczema and Contact Dermatitis Pyodermas Systemic Diseases Surgical Technique Genetic Disorders With Nail Changes Trauma Transverse Figure-of-Eight Suture for Securing the Toenail Crush Injuries to the Nail Subungual Hematoma Tumors Glomus Tumor Subungual Exostosis and Osteochondroma Resection of Subungual Exostosis Surgical technique Results. Melanotic Whitlow and Malignant Melanoma Other Tumorous Conditions Onychopathies And Other Common Nail Abnormalities Common Nail Plate Disorders Onychocryptosis Treatment. Onychauxis and Onychogryphosis Treatment. Onychomycosis Distal subungual onychomycosis. White superficial onychomycosis. Proximal subungual onychomycosis. Candidal onychomycosis. Diagnosis. Systemic treatment. Local treatment. Topical treatment. Combination treatment: Topical, systemic, debridement. Onychia Onycholysis and Onychomadesis Onychopsittacus Nail Bed Disorders Subungual Exostosis and Subungual Tumors Subungual Clavus Subungual Hematoma Subungual Verruca Paronychia Treatment of acute paronychia (Video 14-1). Treatment of chronic paronychia (Videos 14-2–14-5). En bloc excision of the proximal nail fold and avulsion of nail plate.196 Surgical Technique Results Onychophosis Pyogenic Granuloma Herpetic Whitlow Periungual Verruca Nail Fold Disorders Nail Matrix Disorders Anonychia Pterygium Atrophy and Hypertrophy Pathologic Keratinization Conservative and Surgical Treatment Digital Anesthetic Block (Video 6-3) Technique. Partial Nail Plate Avulsion (Video 14-1) Surgical technique. Fig. 14-47 see Fig. 14-9 Complete Toenail Avulsion Surgical technique. Lateral Fold Reduction Surgical technique. Lateral Fold Advancement Flap Surgical technique. Results and complications. Partial Onychectomy (Winograd or Heifetz Procedure) (Videos 14-2 and 14-3) Surgical technique (Fig. 14-47 see Fig. 14-9) Results and complications. Alternative procedure. Complete Onychectomy (Zadik Procedure) (Video 14-4) Surgical technique. Postoperative care. Results and complications. Alternative procedure. Terminal Syme Amputation (Thompson-Terwilliger Procedure) (Video 14-5) Surgical technique. Postoperative care. Results and complications. Chemical Matrixectomy Surgical technique. Postoperative care. Results and complications. References 15. Soft Tissue Disorders of the Foot 15 Soft Tissue Disorders of the Foot BURNS Burn Management Contractures Malignant Changes Cast-Related Burns Electrical Burns Chemical Burns Radiation Burns EXPOSURE Frostbite Chilblain Trench Foot FOREIGN BODY INJURIES BLISTERS Friction Blisters Fracture Blisters PLANTAR HYPERHIDROSIS AND BROMHIDROSIS Treatment THE POLYSURGICAL FOOT CRIPPLE Initial Evaluation History Physical Examination PSYCHIATRIC ASPECTS OF PAIN Hypochondriac Illness Hysteric Conversion (Functional Neurological Symptom Disorder) Malingering and Factitious Disorder Evaluation and Referral COSMETIC FOOT SURGERY References 16. Dermatology of the Foot and the Lower Extremity 16 Dermatology of the Foot and the Lower Extremity DIAGNOSING SKIN DISEASE ON THE LOWER EXTREMITY Observe Ask ENVIRONMENTALLY INDUCED SKIN DISORDERS Sun Exposure Heat and Cold Bites and Stings and Infestations Trauma GENODERMATOSES: HYPERKERATOTIC DISORDERS ON THE PLANTAR SKIN Treatment of Genodermatoses BACTERIAL INFECTIONS Impetigo Cellulitis Folliculitis Pitted Keratolysis/Erythrasma Pseudomonas Hot Foot Syndrome VIRAL INFECTIONS Viral Exanthems Measles Rubella Fifth Disease or Erythema Infectiosum Varicella/Zoster Herpes Simplex Hand, Foot, and Mouth Disease Molluscum Contagiosum Verrucae FUNGAL INFECTIONS ECZEMA/DERMATITIS Atopic Dermatitis Juvenile Plantar Dermatosis (Sweaty Sock Dermatitis) Pompholyx (Dyshidrotic Eczema) Allergic Contact Dermatitis Irritant Contact Dermatitis Focus on Eczema/Dermatitis of the Lower Extremity General Management of Eczema PSORIASIS Plaque Psoriasis Pustular Psoriasis Guttate Psoriasis Focus on Psoriasis of the Lower Extremity General Management of Psoriasis BENIGN AND MALIGNANT LESIONS Benign Lesions Malignant Lesions NAILS References PART IV. Tumors 17. Soft Tissue and Bone Tumors 17 Soft Tissue and Bone Tumors Clinical Evaluation History Physical Examination Imaging Studies Radiographs Computed Tomography Magnetic Resonance Imaging Nuclear Imaging Staging Biopsy Radiation for Foot and Ankle Tumors Chemotherapy for Foot and Ankle Tumors General Principles of Surgical Treatment for Soft Tissue and Bone Tumors Benign Soft Tissue Tumors Fibroma and Fibromatosis Desmoid Tumors (Aggressive Fibromatosis) Dermal Tumors Dermatofibroma (Benign Fibrous Histiocytoma) Granuloma Annulare Vascular Tumors and Malformations Hemangioma Arteriovenous Malformations Glomus Tumor Neural Tumors Schwannoma (Neurilemoma) Neurofibroma Lipomatous Tumors Lipoma Atypical Lipomatous Tumors (ALT) Synovial Tumors and Tumor-Like Conditions Ganglion Tenosynovial Giant Cell Tumor Synovial Chondromatosis Metabolic Deposition Lesions Tendon Xanthoma Tophaceous Gout Malignant Soft Tissue Tumors Soft Tissue Sarcoma Malignant Melanoma Basal and Squamous Cell Carcinoma Soft Tissue Metastases Benign Bone Tumors and Tumor-Like Conditions General Principles Bone-Forming Tumors Osteochondroma Osteoid Osteoma Osteoblastoma Bizarre Parosteal Osteochondromatous Proliferation Subungual Exostosis Cartilage-Forming Tumors Enchondroma Periosteal Chondroma Chondroblastoma Chondromyxoid Fibroma Benign Aggressive Bone Tumors Aneurysmal Bone Cyst Giant Cell Tumor of Bone Cystic Bone Lesions Simple Bone Cyst Intraosseous Lipoma Intraosseous Ganglion and Degenerative Bone Cyst Epidermoid Inclusion Cyst Tumor-Like Conditions of Bone Langerhans Cell Histiocytosis Hyperparathyroidism (Brown Tumor) Malignant Bone Tumors General Principles Chondrosarcoma Osteosarcoma Ewing Sarcoma Metastatic Carcinoma References PART V. Nerve Disorders 18. Disorders of the Nerves 18 Disorders of the Nerves ANATOMY AND DEFINITION OF INJURY ELECTRODIAGNOSTIC STUDY INTERDIGITAL NEUROMA/NEURALGIA Etiology Pathophysiology Anatomic Factors Communicating nerve and accessory branches. Mobility. Traumatic Causes Extrinsic Factors Intermetatarsal bursa. Metatarsophalangeal joint deviation. Metatarsal fracture. Ischemic Factors Clinical Presentation Diagnosis Physical Examination MTP joints. Webspaces. Neurologic examination. Serial examination. Differential Diagnosis Diagnostic Studies Radiographs. Ultrasound. MRI. Electrophysiologic testing. Diagnostic injection. Conservative Treatment Footwear Webspace Injections Anesthetic injection. Corticosteroid injection. Other injections, radiofrequency ablation, and other treatments. Surgical Treatment Neurectomy Neurolysis (Transverse Intermetatarsal Ligament Release) Intramuscular Implantation Adjacent Interdigital Neuromas (Second and Third Webspaces) Dorsal Surgical Approach (Video 18-1) Neurectomy: surgical technique. Neurolysis of the common digital nerve and its terminal branches. Surgical technique. Postoperative care. Uncommon findings. Results. Plantar Surgical Approach Transverse approach: surgical technique. Longitudinal approach: surgical technique. RECURRENT INTERDIGITAL NEUROMAS Diagnosis Treatment Conservative Treatment Surgical Excision Excision of recurrent neuroma. Surgical technique. Interdigital Neuroma/Neuralgia - Surgical treatment. Postoperative care. Uncommon findings. Other Treatments TARSAL TUNNEL SYNDROME Anatomy Medial Calcaneal Nerve Lateral Plantar Nerve First Branch of the Lateral Plantar Nerve Medial Plantar Nerve Distal Tarsal Tunnel Syndrome Etiology Clinical Symptoms Diagnosis Physical Examination Radiographic Findings Magnetic resonance imaging. Ultrasound. Electrodiagnostic Studies Differential Diagnosis Conservative Treatment Surgical Treatment Tibial Nerve Release (Video 18-2) Open release. Surgical technique. Postoperative care. Results. Endoscopic tarsal tunnel release. FAILED TARSAL TUNNEL RELEASE Overview and Etiology Evaluation Conservative Treatment Surgical Treatment Revision Neurolysis Revision with wrap or conduit. Surgical technique. Revision with a saphenous vein wrap. Surgical technique. Postoperative care. Results. Peripheral Nerve Stimulation for Failed Tarsal Tunnel Release Technique for Peripheral Nerve Stimulation Surgical technique. Postoperative care. Results. Spinal Cord Stimulation Amputation TRAUMATIC NERVE INJURIES Clinical Symptoms Diagnosis Principles of Treatment Conservative Treatment Surgical Treatment Acute Nerve Transections Neuromas Nerve Transection and Burial (Video 18-3) Surgical technique. Postoperative care. Results. FIRST BRANCH OF THE LATERAL PLANTAR NERVE ENTRAPMENT Anatomy Incidence Etiology Clinical Symptoms Diagnosis Release of the First Branch of the Lateral Plantar Nerve Surgical Technique Postoperative Care Results CALCANEAL BRANCHES Overview, Etiology, and Anatomy Evaluation Management Results MEDIAL PLANTAR NERVE ENTRAPMENT Incidence Etiology Clinical Symptoms Diagnosis Medial Plantar Nerve Release Surgical Technique SUPERFICIAL PERONEAL NERVE ENTRAPMENT Incidence Etiology Clinical Symptoms Diagnosis Conservative Treatment Superficial Peroneal Nerve Release Surgical Technique Postoperative Care Results DEEP PERONEAL NERVE ENTRAPMENT Etiology Evaluation History Physical Examination Diagnostic Studies Conservative Treatment Deep Peroneal Nerve Release Surgical Technique Postoperative Care Results SURAL NERVE ENTRAPMENT Etiology Clinical Symptoms Diagnosis Conservative Treatment Sural Nerve Release Surgical Technique Postoperative Care Results SAPHENOUS NERVE ENTRAPMENT Overview, Etiology, and Anatomy Evaluation History Physical Examination Diagnostic Studies Conservative Treatment Surgical Treatment SUMMARY References 19. Congenital and Acquired Neurologic Disorders 19 Congenital and Acquired Neurologic Disorders GENERAL CONSIDERATIONS Orthopaedic Assessment as Part of a Functional Treatment Plan Etiology Lower Extremity Assessment Coexisting Conditions Planning for Surgical Intervention Overview of Deformity Management Energy Conservation CONGENITAL NEUROLOGIC CONDITIONS Charcot-Marie-Tooth Disease Treatment Approach Surgical Treatment Plantar fascia release. Surgical technique (Video 12-1). Lateralizing calcaneal tuberosity osteotomy (Videos 30-5 and 30-6). Surgical technique for traditional open approach. Surgical technique for the MIS calcaneal osteotomy (Video 19-1 and Fig. 19-12). Metatarsal osteotomy (Video 30-4). Surgical technique. Peroneus longus tendon transfer (Video 30-3). Surgical technique. Posterior tibial tendon transfer. Surgical technique. Modified Jones procedure (Video 30-2). Surgical technique. Correction of lesser toes. Salvage procedures. Results. Myelomeningocele Sensory Deficits Treatment Approach Cast treatment. Talipes Equinovarus Conservative treatment. Surgical treatment—correction of clubfoot. Surgical technique. Postoperative care. Midfoot osteotomy. Surgical technique. Congenital Vertical Talus Surgical treatment—correction of vertical talus. Surgical technique. Equinus Deformity Surgical treatment. Calcaneal Deformity Conservative treatment. Surgical treatment—anterior tibial tendon transfer. Surgical technique. Postoperative care. Valgus Deformity Conservative treatment. Surgical treatment. Calcaneocavus Deformity Conservative treatment. Surgical treatment. Cerebral Palsy Equinus Deformity Surgical treatment. Recession of gastrocnemius aponeuroses surgical technique(Video 29-2). Percutaneous heel cord lengthening surgical technique. Results. Equinovarus Deformity Surgical treatment. Split posterior tibial tendon transfer surgical technique. Equinovalgus Deformity Conservative treatment. Surgical treatment. Evans procedure surgical technique (Fig. 19-37) Miller procedure (plantar-flexion arthrodesis of naviculomedial cuneiform articulation) surgical technique (Fig. 19–38) Calcaneal bone graft surgical technique. Hallux Valgus Duchenne Muscular Dystrophy ACQUIRED NEUROLOGIC DISORDERS Cerebrovascular Accident (Stroke) Conservative Treatment Open phenol nerve block to tibial nerve injection technique.140 Equinovarus Deformity Split anterior tibial tendon transfer surgical technique. Triceps surae contracture. Claw toes. Results. Spastic Flatfoot Traumatic Brain Injury Spinal Cord Injury Peripheral Nerve Injury Peroneal Nerve Injuries Posterior tibial tendon transfer. Bridle procedure. Surgical technique. Postoperative care. Results. Sciatic Nerve Injuries Postpolio Syndrome Parkinson Disease Amyotrophic Lateral Sclerosis Painful Leg–Moving Toes Syndrome References 20. Complex Regional Pain Syndrome 20 Complex Regional Pain Syndrome HISTORY NOMENCLATURE CLINICAL PRESENTATION PHYSIOLOGY Complex Regional Pain Syndrome Type I Complex Regional Pain Syndrome Type II PSYCHIATRIC MANIFESTATIONS DEMOGRAPHICS DIFFERENTIAL DIAGNOSIS PHYSICAL EXAMINATION DIAGNOSTIC EVALUATION CONSERVATIVE TREATMENT Physical Therapy Nonpharmacologic Options Desensitization and Graded Exposure Transcutaneous Nerve Stimulation Acupuncture Nerve Blocks Other Methods PHARMACOLOGIC AGENTS* Acetaminophen (Paracetamol) Antiinflammatory Medications Nonsteroidal Antiinflammatory Drugs Corticosteroids Bisphosphonates Antioxidants and Free-Radical Scavengers Anti-Tumor Necrosis Factor Medications Antineurosensitization Medications Anticonvulsants Ketamine Cannabinoids Vasomotor Regulatory Mediations Calcium Channel Blockers Sympatholytics Medications for Motor Dysregulation Other Medications Opioids Atypical Opioids Tricyclic Antidepressants Calcitonin Topical Treatments Injections INVASIVE THERAPIES SURGICAL TREATMENT PEDIATRIC VERSUS ADULT REGIMENS Acknowledgment References PART VI. Arthritis 21. Arthritis of the Foot 21 Arthritis of the Foot ARTHRITIC CONDITIONS OF THE FOOT Overview Degenerative Joint Disease History and Physical Examination Radiographic Examination Treatment DEGENERATIVE ARTHRITIS OF THE HINDFOOT Subtalar Arthrodesis Calcaneocuboid Arthrodesis Talonavicular Arthrodesis Double Arthrodesis Triple and Pantalar Arthrodesis DEGENERATIVE ARTHRITIS OF THE MIDFOOT Treatment INFLAMMATORY ARTHROPATHIES Rheumatoid Arthritis History and Physical Examination Forefoot Pathophysiology. Disease progression. Midfoot Hindfoot Imaging Modalities Microscopic Examination Diagnosis Treatment Pharmacologic Therapy Conservative Management Surgical Management Lesser Metatarsophalangeal Joint Synovectomy Surgical technique. Postoperative care. Results and complications. Rheumatoid Hammer Toe Repair Surgical technique. Alternative method: closed osteoclasis. Postoperative care. Results and complications. Rheumatoid Forefoot Reconstruction (Video 21-1) Lesser metatarsophalangeal joint resection arthroplasty. Surgical technique. Postoperative care. Results and complications. First MTP joint arthrodesis and lesser MTP joint resection arthroplasty. First MTP joint resection arthroplasty and lesser MTP joint resection arthroplasty. Transmetatarsal amputation. Pan-metatarsophalangeal joint arthrodesis. Avoiding revision surgery. First Metatarsophalangeal Joint Arthrodesis Cup and Cone Reamer With Plate and Screw Fixation (See Video 27-3) Surgical technique. Postoperative care. Intramedullary Fixation (See Video 27-5) Surgical technique. Postoperative care. Intramedullary Fixation and Interpositional Graft (See Video 27-4) Surgical technique. Postoperative care. Results and complications. Alternative Treatment of the First Metatarsophalangeal Joint Resection Arthroplasty (See Video 7-10) Silicon Implant Arthroplasty Other Treatments Joint Preserving Forefoot Surgery Uncommon Problems Associated With Rheumatoid Arthritis Subluxation or Dislocation of a Single Metatarsophalangeal Joint Interphalangeal Joint Arthritis of the Hallux (See Video 27-6) Rheumatoid Nodule or Cyst Splaying of the Rheumatoid Foot JUVENILE IDIOPATHIC ARTHRITIS CRYSTAL-INDUCED ARTHROPATHIES Gouty Arthropathy History and Epidemiology Pathophysiology Treatment Calcium Pyrophosphate Dihydrate Deposition Disease (Pseudogout) Incidence Pathophysiology Treatment SERONEGATIVE ARTHROPATHIES Psoriatic Arthritis Definition and Incidence Examination Treatment Reactive Arthritis Presentation and Etiology Treatment Systemic Lupus Erythematosus Presentation, Etiology, and Incidence Treatment Ankylosing Spondylitis Presentation and Etiology Treatment Dish Syndrome Human Immunodeficiency Virus Infection and Inflammatory Arthropathies MISCELLANEOUS ARTHROPATHIES OF THE FOOT AND ANKLE Lyme Disease Presentation and Etiology Diagnosis Treatment Fibromyalgia References 22. Ankle Arthritis and Arthrodesis 22 Ankle Arthritis and Arthrodesis PREVALENCE OF ANKLE OSTEOARTHRITIS Autopsy Studies Radiographic Evaluations Clinical Studies PATHOGENESIS OF ANKLE ARTHRITIS Posttraumatic Arthritis Arthritis Secondary to Other Diseases Primary Arthritis: Protective Characteristics of the Ankle Joint Anatomy and Motion Articular Tensile Properties Articular Cartilage Metabolism CLINICAL IMPACT OF ANKLE ARTHRITIS APPROACH TO THE PATIENT WITH ANKLE ARTHRITIS History and Physical Examination Ankle Joint Imaging Radiography Magnetic Resonance Imaging Ultrasound Computed Tomography and Nuclear Medicine Scans Selective Injections NONOPERATIVE TREATMENT OF ANKLE ARTHRITIS Medications Injections Corticosteroids Viscosupplementation, Platelet-Rich Plasma, and Mesenchymal Stem Cell Injections Bracing and Shoe Modifications OPERATIVE TREATMENT OF GLOBAL ANKLE ARTHRITIS Ankle Fusion Surgical Considerations Advantages of ankle fusion. Disadvantages of ankle fusion. Limb alignment. Soft-tissue considerations. Basic Surgical Principles Position of arthrodesis. Open Ankle Arthrodesis (Videos 22-1 through 22-4) Indications. Preparation. Open techniques. Lateral transfibular approach (Video 22-1). Flat-cut (Mann) technique. Lateral approach with in situ joint preparation. Lateral approach using cannulated screws. Lateral approach with fibular onlay. Alternative screw placement. Lateral plate technique (Video 22-2). Wedge graft. Multiple modifications. Anterior approach (Videos 22-3 and 22-4). Open plating. Posterior approach. Open plating. Medial approach. Open plating. Minimally Invasive Ankle Arthrodesis Indications. Preparation. Minimally invasive techniques. Anterior Approach. Arthroscopic technique. Mini-open technique. Combined technique. Postoperative Care Fusion Using an External Fixator Ankle Fusion Outcomes Fusion. Patient-reported outcomes. Range of motion and gait. Hindfoot arthritis. Complications Nonunion and malunion. Bone and joint complications. Soft tissue complications. Bipolar Osteochondral Allograft Ankle Joint Resurfacing Distraction Arthroplasty OPERATIVE TREATMENT OF ASYMMETRIC, LOCALIZED ANKLE ARTHRITIS (See Video 22-5) Distal Tibia Malalignment—Open Correction Distal Tibia Osteotomy—Open Technique for Coronal Plane Deformities Distal Tibia Osteotomy—Open Technique for Sagittal Plane Deformities Foot Deformities Associated With Localized Ankle Arthritis SURGERY FOR FAILED PREVIOUS FUSION SURGERY Nonunion Malunion Secondary Subtalar Arthritis Acknowledgments References 23. Ankle Replacement 23 Ankle Replacement A SHORT HISTORY OF TOTAL ANKLE REPLACEMENT Early and First-Generation Designs Second-Generation Designs Third-Generation Designs PREPARING FOR A SUCCESSFUL TOTAL ANKLE REPLACEMENT Patient Selection Indications for Total Ankle Replacement Contraindications for Total Ankle Replacement Aligning Patient and Surgeon Expectations Clinical Examination Radiographic Examination Learning Curve in Total Ankle Replacement OPERATIVE TREATMENT OF ANKLE ARTHRITIS WITH TOTAL ANKLE REPLACEMENT Surgical Techniques for Neutrally Aligned Ankles Anterior Approach (Videos 23-1 through 23-6) Lateral Approach (Video 23-7) Surgical Techniques for Associated Angular Deformities Deformity Assessment Deformity Proximal to the Ankle (Video 23-8) Total Ankle Replacement in the Valgus Osteoarthritic Ankle Morphologic types of the valgus osteoarthritic ankle. Surgical technique of total ankle replacement in the valgus osteoarthritic ankle. Total Ankle Replacement in the Varus Osteoarthritic Ankle Morphologic types of the varus osteoarthritic ankle. Surgical technique of total ankle replacement in the varus osteoarthritic ankle. RESULTS OF TOTAL ANKLE REPLACEMENTS Implant Survival Registry Data and Systematic Review Cemented Versus Uncemented Implantation Patient Age Etiology of Arthritis Implant Design Preoperative Alignment Postoperative Alignment and Implant Positioning Concomitant Procedures (Videos 23-9 and 23-10) Objective Outcome Measures Kinematics and Biomechanics Gait, Kinetics, and Balance Pedobarographics Outcomes Compared With Fusion Adjacent Joints Function and Return to Sport Cost–Benefit Analysis Outcome by Implant Design Outcome of Patient-Specific Instrumentation Outcomes After Prior Fusion Patient-Reported Outcome Measures Outcome Instruments in Studies on Total Ankle Arthroplasty MANAGING COMPLICATIONS OF TOTAL ANKLE REPLACEMENT Types of Problems Encountered Infection and Delayed Wound Healing Fracture (Video 23-11) Osteolysis Progressive Intracomponent Instability and Deformity Subsidence Polyethylene Wear and Failure Arthrofibrosis and Heterotopic Ossification Pain and Impingement Management Options Bracing Revision Total Ankle Replacement (Video 23-12) Conversion of Total Ankle Replacement to Fusion Acknowledgments References 24. Avascular Necrosis and Total Talus Replacement 24 Avascular Necrosis and Total Talus Replacement INTRODUCTION AND ETIOLOGY IMAGING AND STAGING TREATMENT OF TALAR AVASCULAR NECROSIS (VIDEO 24-1) Preoperative Evaluation Review of Traditional and 3D Printed Arthrodesis for AVN of the Talus 3D PRINTING AND TOTAL TALUS REPLACEMENT Process of Creating a 3D Printed Implant Types of Total Talus Replacement Total Talus Design Considerations Outcome Data for Total Talus Replacement Management of Complications TOTAL TALUS REPLACEMENT CASE EXAMPLES AND TECHNIQUE Case 1: Total Talus Replacement (Video 24-2) Surgical Technique Case 2: Total Ankle Total Talus Replacement Surgical Technique CONCLUSIONS References 25. Hindfoot and Pantalar Arthritis 25 Hindfoot and Pantalar Arthritis PREVALENCE AND PATHOGENESIS CLINICAL APPROACH History, Physical Examination, and Imaging Nonoperative Management Injections Bracing SURGICAL CONSIDERATIONS Alignment Surrounding Joint Arthritis Soft Tissue Considerations Joint-Preserving Surgery Surgical Principles Complications SPECIFIC ARTHRODESES Subtalar Arthrodesis Indications Position of Arthrodesis Open Surgical Technique (Videos 25-1 and 25-2) Deformity correction Joint preparation Internal fixation Closure Arthroscopic Surgical Technique Postoperative Care Results Clinical outcomes. Surgical factors. Distraction subtalar arthrodesis. Arthroscopic subtalar fusion. Complications Talonavicular Arthrodesis Indications Alignment of the Fusion Surgical Technique Postoperative Care Results Complications Calcaneocuboid Arthrodesis Surgical Technique (Video 25-3) Postoperative Care Double (Talonavicular and Calcaneocuboid) Arthrodesis Indications Position of Arthrodesis Surgical Technique (Video 25-4) Postoperative Care Results Special Considerations Modified Double (Subtalar and Talonavicular) Arthrodesis Indications Position of Arthrodesis Surgical Technique—Two Incisions Surgical Approach—Single Medial Incision Postoperative Care Results Triple Arthrodesis Indications Position of Arthrodesis Surgical Approach—Two Incisions (Video 25-5) Surgical Approach—Single Medial Incision Surgical Approach—Single Lateral Incision Postoperative Care Results Complications Revision for Malalignment Tibiotalocalcaneal and Pantalar Arthrodesis Indications Position of Arthrodesis Hardware Considerations Screws. Nails. Plate and screws. External fixation. Grafting Considerations Open Surgical Technique—Lateral Approach (Videos 25-6 through 25-8) Internal fixation—intramedullary nail (see Videos 25-6 and 25-7) Internal fixation—plate and screws (see video 25-8) Closure Open Surgical Technique—Posterior Approach (Video 25-9) Postoperative Care Results Grafting considerations. Hardware considerations. Surgical considerations. Complications Acknowledgments References 26. Midfoot Arthritis 26 Midfoot Arthritis INTRODUCTION ETIOLOGY PHYSICAL EXAMINATION IMAGING STUDIES NONOPERATIVE TREATMENT OPERATIVE TREATMENT Medial Column Exostectomy (Video 26-1) Medial and Middle Column Arthrodesis (Videos 26-2 through 26-6) Surgical Technique Postoperative Care Results Lateral Column Interposition Arthroplasty Surgical Technique Postoperative Care Results Acknowledgments References 27. Hallux Rigidus and Other Forefoot Arthritis 27 Hallux Rigidus and Other Forefoot Arthritis HALLUX RIGIDUS Definition Incidence Signs and Symptoms Etiology History and Physical Examination Radiographic Evaluation Conservative Treatment Surgical Treatment Proximal Phalangeal Osteotomy Surgical technique. Postoperative care. Results and complications. Cheilectomy (Videos 27-1 and 27-2) Surgical technique. Postoperative care. Results and complications. Excisional Arthroplasty Surgical technique. Postoperative care. Soft Tissue Interpositional Arthroplasty Surgical technique. Alternative technique. Postoperative care. Results and complications. First Metatarsal Osteotomy Metatarsophalangeal Joint Arthrodesis (Videos 27-3 through 27-5) Surgical technique. Results and complications. Metatarsophalangeal Joint Arthroplasty Metal-polyethylene joint replacements. Silicone elastomer joint replacement. Salvage of Joint Replacement Silicon Implant Surgical technique78–80. Postoperative care. First Metatarsophalangeal Implant Resection Arthroplasty Surgical technique. Postoperative care. First Metatarsophalangeal Joint Interpositional Arthrodesis Surgical technique. Postoperative care. Results and complications. DEGENERATIVE ARTHRITIS OF THE INTERPHALANGEAL JOINT DEGENERATIVE ARTHRITIS OF THE LESSER TOES References PART VII. Tendon Disorders and Postural Malalignment 28. Disorders of Tendons 28 Disorders of Tendons EXTENSOR TENDONS Anterior Tibial Tendon Anatomy History and Physical Examination Imaging Treatment Considerations Surgical Treatment Primary repair of ruptured anterior tibial tendon. Surgical technique. Free tendon graft for retracted anterior tibial tendon rupture(Videos 28-1 and 28-2). Surgical technique. Extensor hallucis longus transfer for anterior tibial tendon rupture with fibrotic or atrophic tibialis anterior muscle. Surgical technique. Alternate techniques. Postoperative care. Results and Complications Conclusion Extensor Hallucis Longus Anatomy History and Physical Examination Surgical Treatment (Video 28-3) Results and Complications Conclusion Extensor Digitorum Longus Anatomy Physical Examination Surgical Treatment Results Extensor Digitorum Brevis FLEXOR TENDONS Flexor Digitorum Longus Rupture History and Physical Examination Surgical Treatment Flexor Hallucis Longus Flexor Hallucis Longus Tenosynovitis History and Physical Examination Radiographic Examination Conservative Treatment Surgical Treatment Open release of the flexor hallucis longus. Surgical technique. Excision of the os trigonum through a lateral approach (see Video 28-4). Surgical technique. Excision of the os trigonum through a medial approach77,126 (see Video 28-4). Surgical technique. Postoperative care. Results Flexor Hallucis Longus Rupture History and Physical Examination Radiographic Examination Surgical Treatment Primary repair of ruptured FHL tendon. Surgical technique. Postoperative care. Results and Complications PERONEAL TENDONS Peroneus Longus Anatomy Pathology Stenosing Tenosynovitis Etiology. History and physical examination. Radiographic examination. Conservative treatment. Surgical treatment. Peroneal tenosynovectomy. (Video 28-7). Surgical technique. Postoperative care. Results. Peroneus Longus Disruption History and physical examination. Radiographic examination. Conservative treatment. Surgical treatment. Os peroneum excision. Surgical technique (Fig. 28-76). Postoperative care. Peroneal tendon tenodesis212 (Video 28-8) Surgical technique. Postoperative care. Results. Longitudinal Tears and Degeneration Peroneus Brevis Anatomy Etiology History and Physical Examination Radiographic Examination Conservative Treatment Surgical Treatment Tendon debridement and repair (Videos 28-9 through 28-12). Surgical technique. Postoperative care. Tendon debridement and repair with turn-down of proximal tendon. Surgical technique. Postoperative care. Tendon debridement and repair with free graft transfer. Surgical technique (Fig. 28-88). Postoperative care. Tendon debridement and repair with tenodesis. Surgical technique. Postoperative care. Flexor digitorum longus transfer for peroneus brevis lesions (Videos 28-13 and 28-14). Surgical technique. Postoperative care. Results and Complications Combined Tears of the Peroneus Brevis and Longus Tendons Peroneal Tendon Subluxation–Dislocation Anatomy Mechanism of Injury History and Physical Examination Radiographic Examination Conservative Treatment of Acute Dislocation Surgical Treatment (Videos 28-15 through 28-17) Direct superior peroneal retinaculum repair. Surgical technique. Postoperative care. Chronic dislocation. Superior peroneal retinaculum reinforcement and repair. Tissue-transfer techniques. Tendon-rerouting techniques. Bone-block procedures. Groove-deepening procedures. Groove deepening with a posterior osteocartilaginous flap. Surgical technique. Alternative techniques. Postoperative care. Results and Complications Intrasheath Peroneal Subluxation Conclusion POSTERIOR TIBIAL TENDON SUBLUXATION–DISLOCATION Anatomy Surgical Treatment Repair Dislocating Posterior Tibial Tendon (Fig. 28-119) Surgical technique. Postoperative care. Results TENDON TRANSFERS Biomechanical Principles Principles of Muscle Function Patient Evaluation Natural History of Muscle Imbalance Age of Patient Diagnosis Surgical Treatment Surgical Principles Anterior Tendon Transfer Posterior tibial tendon transfer to the dorsum of the foot. Surgical technique (Fig. 28-123). Postoperative care. Results. Split Tendon Transfer Posterior Tendon Transfer Lateral Tendon Transfer Distal Tendon Transfer References 29. Pes Planus 29 Pes Planus PES PLANUS PROGRESSIVE COLLAPSING FOOT DEFORMITY History Anatomy and Function of the Tibialis Posterior Tendon and Medial Arch Pathophysiology of Progressive Collapsing Foot Deformity—Posterior Tibial Tendon Dysfunction Etiology Acute Chronic Mucinous degeneration. Inflammation. Blood supply. Anatomic factors. Physical Findings Clinical Staging Imaging Evaluation Radiography Computed Tomography Magnetic Resonance Imaging Ultrasonography Conservative Treatment Rest and Activity Modification Medication Exercises Orthotics and Bracing Surgical Treatment for Tibialis Posterior Tenosynovitis Tenosynovectomy Indications. Contraindications. Preoperative evaluation. Surgical technique—open tenosynovectomy (Video 29-1). Postoperative care. Results and complications. Surgical Treatments for Flexible Deformity Flexor Digitorum Longus Tendon Transfer Indications. Contraindications. Preoperative evaluation. Preoperative planning. Surgical technique—flexor digitorum longus transfer (Video 29-3). Postoperative care. Results and Complications Calcaneal Osteotomy Indications. Contraindications. Preoperative evaluation and planning. Surgical technique—open calcaneal osteotomy (Video 29-6). Postoperative care. Results and complications. Spring Ligament Repair and Reconstruction Indications. Contraindications. Preoperative planning. Surgical technique—spring ligament repair. Surgical technique—spring ligament reconstruction. Results and complications. Plantar-Flexion Opening-Wedge (Cotton) Osteotomy of the Medial Cuneiform Indications. Contraindications. Preoperative evaluation and planning. Surgical technique for Cotton osteotomy. Results and complications. Lateral Column Lengthening Indications. Contraindications. Preoperative evaluation. Surgical technique for lateral column lengthening (Evans procedure). Surgical technique for lateral column lengthening (step-cut osteotomy) (Video 29-7). Results. Naviculocuneiform Arthrodesis Indications and contraindications. Surgical technique—naviculocuneiform fusion. Surgical technique—proximal tibial bone graft harvest. Postoperative care. Results. Treatment of Deltoid Insufficiency Indications. Contraindications. Preoperative evaluation and planning. Surgical technique for deltoid reconstruction. A. Two-distal tunnels allograft suture-button and post fixation (Haddad technique).204 B. One-distal tunnels peroneus longus autograft post fixation (Deland technique).203 C. Two-distal tunnels allograft interference screw fixation percutaneous (Myerson technique).202,205 Postoperative care. Results and complications. Surgical Treatments for Rigid Deformity Subtalar Arthrodesis to Treat Progressive Collapsing Foot Disorder Surgical technique for subtalar arthrodesis. Surgical technique for triple arthrodesis. Single and Double Arthrodesis Triple Arthrodesis Results and complications. Acknowledgment References 30. Pes Cavus 30 Pes Cavus ETIOLOGY Charcot-Marie-Tooth Disease Poliomyelitis Patterns of Foot Deformity in Polio Hindfoot cavus. Forefoot cavus. Other deformities. Other Neurologic Lesions Posttraumatic Cavovarus Foot Deformities Congenital Pes Cavus Clubfoot Residuals The Idiopathic Cavus Foot EVOLUTION OF DEFORMITY BIOMECHANICAL CONSEQUENCES OF PES CAVUS EVALUATION AND TREATMENT OF PES CAVUS Physical Examination Investigations Nonoperative Treatment Surgical Treatment Decision Making Incision Planning Soft Tissue Procedures Plantar Fascia Release (Steindler Stripping) (See Video 12-1) Surgical technique. Postoperative care. First-Toe Jones Procedure (Video 30-2) Surgical technique. Postoperative care. Peroneus Longus to Brevis Transfer (Video 30-3) Surgical technique. Postoperative care. Tibialis Anterior Transfer to Third Cuneiform Surgical technique. Postoperative care. Results and complications. Posterior Tibialis Transfer Claw Toe Corrections Lateral Ligament Repair/Reconstruction Bony Procedures Dorsiflexion Osteotomy of the First Ray Dorsiflexion osteotomy of the first metatarsal (Video 30-4). Surgical technique. Postoperative care. Calcaneal Osteotomies Dwyer calcaneal osteotomy with optional lateral and/or dorsal translation (see Video 30-5). Surgical technique. Postoperative care. Results and complications. Minimally invasive lateralizing calcaneal osteotomy. Surgical technique (saw method). Postoperative care. Results and complications. Midtarsal Osteotomies Arthrodesis Procedures Outcomes References 31. Ring External Fixation in the Foot and Ankle 31 Ring External Fixation in the Foot and Ankle OVERVIEW Limb Axis Malalignment and Ankle Arthritis PRINCIPLES OF DEFORMITY EVALUATION AND CORRECTION Normal Alignment and Deformity Measurement Radiographic Evaluation Digital Versus Plain Radiographs Compensatory Deformities Deformity Correction SUPRAMALLEOLAR DEFORMITY CORRECTION Supramalleolar Deformity Classification Osteotomy Location for Supramalleolar Deformity Tibial and Fibular Osteotomy Surgical Techniques Multiple Drill Hole Osteotomy (Fig. 31-19) Surgical technique. Gigli Saw Osteotomy (Fig. 31-20) Surgical technique. Fibular Osteotomy Surgical technique. Hexapod Frame Application for Supramalleolar Deformity Surgical Technique Pin Care Frame Removal ANKLE DISTRACTION Frame Application for Ankle Distraction Surgical Technique Tibial base frame. Ankle hinge for hinged distraction. Foot ring. Ankle distraction. Aftercare. ANKLE DISTRACTION AND DEFORMITY CORRECTION: RESULTS AND COMPLICATIONS Results Complications INTRAARTICLUAR DEFORMITY STRATEGIES ANKLE AND SUBTALAR CONTRACTURE Equinus Gradual Correction With Ring Fixation Surgical Technique FOOT DEFORMITY Osteotomy Types and Locations Results and Complications STATIC MODE RING FIXATION References PART VIII. Diabetes and Infection 32. The Diabetic Foot and Neuroarthropathy 32 The Diabetic Foot and Neuroarthropathy BACKGROUND PATHOPHYSIOLOGY OF DIABETIC ORGAN SYSTEM DISEASE Metabolic Control Diabetic Organ System Disease Peripheral Neuropathy Angiopathy Structural Changes Immune Deficiency Morbid Obesity Central Neuropathy and Judgment Deficits TEAM APPROACH FOR CARE OF THE DIABETIC FOOT Preventive Strategies Risk Stratification Patient Education Skin and Nail Care Therapeutic Footwear DIAGNOSTIC EVALUATION OF THE DIABETIC FOOT Physical Examination of the Diabetic Foot Radiographic Evaluation Vascular Evaluation Laboratory Evaluation Wound-Healing Potential DIABETIC FOOT ULCERS AND FOOT INFECTION Biomechanical Model for the Development of Diabetic Foot Wounds Clinical Presentation Classification of Diabetic Foot Ulcers Wagner Grade 0: Pre-Ulcerative or Post-Healing Wagner Grade 1: Superficial Ulcer Wagner Grade 2: Full-Thickness Ulceration Not Continuous With Bone Wagner Grade 3: Deep Infection—Abscess—Osteomyelitis Wagner Grade 4: Forefoot Gangrene Wagner Grade 5: Whole Foot Gangrene TREATMENT OF DIABETIC FOOT ULCERS AND INFECTION Wagner Grade 0 Wagner Grades 1 and 2 Wagner Grade 3 Wagner Grades 4 and 5 COMORBIDITIES ASSOCIATED WITH THE DIABETIC FOOT Peripheral Neuropathy Peripheral Vascular Disease NEUROPATHIC (CHARCOT FOOT) ARTHROPATHY Pathophysiology Clinical Presentation Evaluation and Treatment CLASSIFICATION OF CHARCOT FOOT DEFORMITY SURGICAL TREATMENT OF CHARCOT FOOT ARTHROPATHY Exostectomy Motor Balancing Midfoot Deformity Hindfoot Deformity Nonunion Surgical Stabilization of the Charcot Foot NEUROPATHIC (CHARCOT ARTHROPATHY) ANKLE Why Is the Ankle Different? Ankle Fractures in Diabetics Neuropathic (Charcot) Ankle Deformity AMPUTATION Acknowledgments References 33. Infections of the Foot and Ankle 33 Infections of the Foot and Ankle CLASSIFICATION SOFT TISSUE INFECTIONS Erythrasma Cellulitis Necrotizing Fasciitis Abscesses NATIVE JOINT INFECTIONS TOTAL ANKLE REPLACEMENT INFECTIONS OSTEOMYELITIS BIOFILMS LOCAL ANTIBIOTICS BY IMPLANTABLE DEVICE COMMON ORGANISMS Bacterial Infections Staphylococcus Species Streptococcus Species Pasteurella multocida Clostridium Species Neisseria gonorrhoeae Aeromonas hydrophila Borrelia burgdorferi Fungal Infections Tinea Pedis Onychomycosis Candida Species Coccidioides Species Cryptococcus neoformans Mycetoma Mycobacteria Tuberculosis Atypical Mycobacteria Parasitic Infections Dermatobia hominis Cutaneous Larva Migrans Chigger Mites SPECIAL CASES Felon Debridement of a Felon Surgical technique Puncture Wounds Animal Bites Human Bites Surgical Wounds Coronavirus Disease (COVID-19) References 34. Amputations of the Foot and Ankle 34 Amputations of the Foot and Ankle* INTRODUCTION GENERAL CONSIDERATIONS SURGICAL CONSIDERATIONS Tourniquets Soft Tissue Preservation Wound Closure Drains Skin Grafting and Flap Coverage Vascular Reconstruction Determination of Amputation Level Other Factors Affecting Healing SPECIFIC AMPUTATION LEVELS AND TECHNIQUES Amputation of the Distal Toe and Nail Surgical Technique Postoperative Care Pitfalls and Complications Amputation of the Great Toe Amputation Through the Proximal Phalanx Base (Video 34-1) Surgical technique. Metatarsophalangeal Disarticulation of the Great Toe Surgical technique. Postoperative care. Pitfalls and Complications Amputation of the Lesser Toes Surgical Technique Postoperative Care Pitfalls and Complications Ray Amputation and Partial Forefoot Amputation Border-Ray Resection Central-Ray Resection (Video 34-2) Multiple-Ray Resections: Partial Forefoot Amputation Postoperative Care Pitfalls and Complications Transmetatarsal Amputation (Video 34-3) Surgical Technique Postoperative Care Pitfalls and Complications Lisfranc Amputation (Tarsometatarsal Disarticulation) Chopart Amputation Surgical Technique Postoperative Care Pitfalls and Complications Partial Calcanectomy Syme Amputation (Video 34-4) Surgical Technique Postoperative Care Results Pitfalls and Complications Below-Knee Amputations Bone-Bridging With Below-Knee Amputation Surgical technique. Results. SUMMARY References 35. Lower Limb Prosthetics 35 Lower Limb Prosthetics PARTIAL FOOT AMPUTATIONS Selecting the Level of Amputation Phalangeal Amputation Surgical Considerations Prosthetic and Biomechanical Considerations Ray Amputation Surgical Considerations Prosthetic and Biomechanical Considerations Transmetatarsal Amputation Surgical Considerations Prosthetic and Biomechanical Considerations Lisfranc Amputation Surgical Considerations Prosthetic and Biomechanical Considerations Chopart Amputation Surgical Considerations Prosthetic and Biomechanical Considerations Boyd and Pirogoff Amputations Surgical Considerations Prosthetic and Biomechanical Considerations ANKLE DISARTICULATION/SYME AMPUTATION Surgical Considerations Prosthetic Considerations Syme Gait TRANSTIBIAL AMPUTATION Surgical Considerations Prosthetic and Biomechanical Considerations Transtibial Socket Design Transtibial Socket and Limb Interface Prosthetic Socks Suspension Mechanisms Progression From Healing to a Definitive Prosthesis Prosthetic Feet and Footwear Transmission of Forces During Prosthetic Gait Frontal Plane Mechanics Sagittal Plane Mechanics SUMMARY References PART IX. Sports Medicine 36. Athletic Soft Tissue Injuries of the Foot and Ankle 36 Athletic Soft Tissue Injuries of the Foot and Ankle ETIOLOGY OF INJURY IN SPORTS Historical Perspective Epidemiology Etiologic Factors Biomechanical Abnormalities Flexibility Strength Footwear and Orthoses Playing Surfaces CHRONIC LEG PAIN IN ATHLETES Differential Diagnosis Incidence Chronic Exertional Compartment Syndrome Etiology Incidence Clinical Features Diagnosis Clinical evaluation. Radiologic evaluation. Pressure measurements. Conservative Treatment Surgical Treatment Anterior compartment fasciotomy. Surgical technique. Lateral compartment fasciotomy. Surgical technique. Deep posterior compartment fasciotomy. Surgical technique. Posterior tibial fasciotomy. Postoperative care. Results. Medial Tibial Stress Syndrome Etiology Clinical Features Diagnostic Imaging Conservative Treatment Surgical Treatment Stress Fractures of the Tibia and Fibula Clinical Features Diagnosis Conservative Treatment Surgical Treatment Gastrocnemius-Soleus Strain Clinical Features Treatment Nerve Entrapment Syndromes Clinical Features Treatment Popliteal Artery Entrapment Syndrome Historical Perspective Classification Incidence Diagnosis Clinical evaluation. Diagnostic studies. Treatment. Venous Disease Delayed-Onset Muscle Soreness LATERAL ANKLE SPRAINS Anatomy Biomechanics Pathology Diagnosis Clinical Evaluation Radiologic Evaluation Talar tilt. Anterior drawer test. Other techniques. Prognosis Classification Prevention Treatment Acute Sprains Conservative treatment of acute sprains. Surgical repair of acute lateral sprains. Surgical technique. Postoperative care. Complications. Chronic Sprains and Instability Conservative treatment of chronic sprains. Surgical treatment of chronic ankle instability. Arthroscopy. Lateral ankle ligament secondary repair or reconstruction. Direct ligament repair (Broström-Gould procedure). Surgical technique. Postoperative care. Anatomic lateral ligament reconstruction with tendon transfer. Surgical technique. Postoperative care. Results. Complications. SYNDESMOSIS (HIGH) ANKLE SPRAINS Incidence and Risk Factors Anatomy Biomechanics Mechanisms of Injury Diagnosis Clinical Evaluation Radiologic Evaluation Routine radiographs. Stress radiographs. Arthrography. Ultrasound. Computed tomography scan. Magnetic resonance imaging. Arthroscopy Classification Treatment Acute Injury Type III. Surgical stabilization of grade III injuries. Surgical technique (see Video 44-2). Postoperative care. Type II. Sprain without diastasis (type I). Subacute injury. Chronic injury. Results. MEDIAL ANKLE SPRAINS Anatomy Biomechanics Diagnosis Clinical Evaluation Radiologic Evaluation Classification Conservative Treatment Surgical Treatment Repair of Acute Medial Ankle Sprain Surgical technique. Postoperative care. CHRONIC MEDIAL LIGAMENT INSTABILITY Diagnosis Treatment SUBTALAR SPRAINS Historical Perspective Anatomy Biomechanics Diagnosis Clinical Evaluation Radiologic Evaluation Stress radiographs. Other techniques. Treatment Acute Versus Chronic Treatment Conservative Treatment Surgical Treatment Secondary anatomic repair. Reconstructive procedures. Triligamentous reconstruction. Surgical technique. Postoperative care. Results. SINUS TARSI SYNDROME Historical Perspective Diagnosis Treatment Conservative Treatment Surgical Treatment MIDFOOT SPRAINS Definition Incidence Mechanisms of Injury Diagnosis Anatomic Considerations Clinical Evaluation Radiologic Evaluation Classification Treatment Summary FOREFOOT SPRAINS—TURF TOE Historical Perspective Epidemiology Severity of Injury Mechanisms of Injury Anatomy Etiologic Factors Diagnosis Clinical Evaluation Classification Radiologic Evaluation Conservative Treatment Surgical Treatment Surgical Techniques (Videos 36-9 through 36-11) Results BUNIONS IN ATHLETES Etiologic Factors Diagnosis Conservative Treatment Surgical Treatment Related Condition Summary Acknowledgments References 37. Achilles Tendon Injuries 37 Achilles Tendon Injuries ANATOMY ACHILLES TENDINOSIS Terminology, Pathology, and Etiology History and Physical Examination Radiographic Examination Nonoperative Treatment Surgical Treatment of Paratenonitis (Videos 37-1 and 37-2) Surgical Technique Postoperative Care Results Surgical Treatment of Insertional Achilles Tendon Dysfunction Excision of Haglund Deformity—Achilles Splitting Approach (Videos 37-3 and 37-4) Surgical technique. Excision of Haglund Deformity—Lateral Approach Surgical technique—lateral approach. Postoperative care. Endoscopic Retrocalcaneal Decompression (Video 37-5) Surgical technique. Postoperative care. Flexor Hallucis Longus Tendon Transfer (Video 37-6) Surgical technique. Postoperative care. Minimally Invasive Zadek Osteotomy Surgical technique103 Postoperative care. Results ACHILLES TENDON RUPTURE Etiology History and Physical Examination Radiographic Examination Nonoperative Treatment Nonoperative Protocol Surgical Treatment of Acute Tear Primary Repair of Achilles Tendon Rupture—Traditional Technique (Video 37-7) Surgical technique. Primary Repair of Achilles Tendon Rupture—Mini-Open Technique (Video 37-8) Surgical technique. Postoperative care. Complications. Achilles Sleeve Avulsions (Video 37-9) Delayed Surgical Treatment Bosworth Repair Surgical technique. Postoperative care. Results. Turn-Down Flap V-Y Advancement Surgical technique. Postoperative care. Results. Conclusion TENDON TRANSFERS TO AUGMENT ACHILLES REPAIR OR RECONSTRUCTION (VIDEO 37-10) Harvest of Long Flexor Hallucis Longus Graft Surgical Technique Harvest of Short Flexor Hallucis Longus Graft Surgical Technique Postoperative Care Results SYNTHETIC AND ALLOGRAFT RECONSTRUCTION PLATELET-RICH PLASMA Acknowledgments References 38. Stress Fractures of the Foot and Ankle 38 Stress Fractures of the Foot and Ankle OVERVIEW Incidence Clinical Presentation Imaging Treatment TIBIAL DIAPHYSEAL STRESS FRACTURES Clinical Features Diagnosis Treatment MEDIAL MALLEOLAR STRESS FRACTURES Clinical Features Radiographs Treatment FIBULAR STRESS FRACTURES Clinical Presentation Radiographic Findings Etiology Treatment SESAMOID STRESS FRACTURES Anatomy and Physiology Diagnosis Conservative Treatment Surgical Treatment Sesamoid Bone Grafting Surgical technique. Postoperative care. Tibial (medial) sesamoidectomy with abductor hallucis tendon transfer. Surgical technique. STRESS FRACTURES OF THE METATARSALS (EXCLUDING THE FIFTH) Incidence Etiology Clinical Presentation Imaging Treatment Metatarsal Stress Fractures in Ballet STRESS FRACTURES OF THE FIFTH METATARSAL Definition and History Classification Anatomy and Biomechanics Incidence Diagnosis Conservative Treatment Surgical Treatment Jones Fracture Limited Open or Percutaneous Repair (Videos 38-1 and 38-2) Surgical technique. Jones Fracture Open Revision Surgical technique. Postoperative care. Results NAVICULAR STRESS FRACTURES Anatomy and Pathophysiology Presentation Radiographic Evaluation Conservative Treatment Surgical Treatment Navicular Stress Fracture Repair Surgical technique. Postoperative care. Complications CALCANEAL STRESS FRACTURES Clinical Presentation Radiographic Examination Treatment References 39. Arthroscopy of the Foot and Ankle 39 Arthroscopy of the Foot and Ankle ARTHROSCOPY OF THE ANKLE IN THE SUPINE POSITION History Advantages and Disadvantages Indications and Contraindications Equipment Arthroscope Instruments Ankle Distractors Positioning and Preparation Arthroscopy Pumps Anesthesia Arthroscopic Portals Anterior Portals Posterior Portals Preferred Portals Portal Complications Surgical Technique Normal Ankle Arthroscopic Anatomy Examination of the Ankle (Video 39-1) Arthroscopic setup and examination. Identifying the superficial peroneal nerve. Joint distraction. Marking external anatomic landmarks. Establishing the anterior portals. Establishing the posterior portal. Intraoperative setup. Postoperative management. ANKLE PATHOLOGY Congenital Plicae Nontraumatic Synovitis Rheumatoid Arthritis Indications and contraindications. Preoperative evaluation and planning. Arthroscopic synovectomy Surgical technique. Results and complications. Tenosynovial Giant Cell Tumor Indications and contraindications. Preoperative evaluation and planning. Surgical treatment. Results and complications. Synovial Osteochondromatosis Indications and contraindications. Preoperative evaluation and planning. Surgical treatment. Results and complications. Hemarthroses Indications and contraindications. Preoperative evaluation and planning. Surgical treatment. Results and complications. Infection Indications and contraindications. Preoperative evaluation and planning. Surgical treatment. Other Inflammatory Arthritides Traumatic Synovitis Indications and Contraindications Nonspecific Generalized Synovitis Preoperative evaluation and planning. Nonspecific Localized Synovitis Preoperative evaluation and planning. Arthroscopic synovectomy. Surgical technique. Postoperative management. Soft Tissue Impingement Anterolateral Impingement Indications and contraindications. Anatomy of anterior soft tissue ankle impingement. Pathology. Preoperative examination and planning. Medial Soft Tissue Impingement Indications and contraindications. Preoperative examination and planning. Posterior Soft Tissue Impingement Indications and contraindications. Anatomy of posterior ankle impingement. Preoperative evaluation and planning. Syndesmotic Impingement Indications and contraindications. Anatomy and pathology of syndesmotic impingement. Preoperative evaluation and planning. Arthroscopy for Soft Tissue Impingement (Video 39-2) Surgical technique. Postoperative care. Results and complications. Loose Bodies and Ossicles Etiology Indications and Contraindications Preoperative Evaluation and Planning Signs and symptoms. Diagnostic evaluation. Surgical Treatment and Results Osteophytes Indications and Contraindications Location Preoperative Evaluation and Planning Signs and Symptoms Surgical Treatment (Video 39-3) Osteophyte resection. Surgical technique. Postoperative care. Results and complications. Posterior Bony Impingement Acute Ankle Fractures Indications and Contraindications Preoperative Evaluation and Planning Arthroscopy for Acute Ankle Fracture Surgical technique. Medial malleolus fracture. Tillaux fracture. Postoperative management. Results and complications. Chronic Ankle Fractures Indications and Contraindications Preoperative Evaluation and Planning Arthroscopy for Chronic Ankle Fracture Surgical technique. Postoperative care. Results and complications. Syndesmotic Instability Background Indications Preoperative Evaluation and Planning Surgical Treatment Surgical technique. Postoperative care. Results and complications. Lateral Ankle Instability Indications and Contraindications Preoperative Evaluation and Planning Arthroscopic Ankle Stabilization Surgical technique. Postoperative care. Medial Ankle Instability and Deltoid Tears Introduction Indications and Preoperative Planning Surgical Treatment Surgical technique. Postoperative care. Traumatic and Degenerative Arthritis Indications and Contraindications Preoperative Evaluation and Planning Arthroscopy for Arthritis Surgical technique. Postoperative care. Results and complications. End-Stage Ankle Arthritis Indications and Contraindications Preoperative Evaluation and Planning Arthroscopic Ankle Arthrodesis Surgical technique. Postoperative care. Results and complications. Discussion ARTHROSCOPY OF THE FOOT IN THE SUPINE POSITION Arthroscopy of the Subtalar Joint Normal Subtalar Arthroscopic Anatomy Indications and Contraindications Preoperative Evaluation and Planning Equipment and Setup Arthroscope. Instruments. Ankle distractors, leg holders, and arthroscopy pumps. Arthroscopic Portals Thirteen-Point Examination of the Subtalar Joint Arthroscopic Examination of the Subtalar Joint (Video 39-4) Surgical technique. Patient positioning. Identifying anatomic landmarks. Portal placement. Diagnostic examination. Postoperative management. Pathology of the Subtalar Joint Synovitis and Loose Bodies Sinus Tarsi Syndrome Preoperative evaluation and planning. Surgical treatment. Os Trigonum Terminology. Indications and contraindications. Preoperative evaluation and planning. Excision of os trigonum in the supine position. Surgical technique. Results and complications. Talus and Calcaneal Fractures Subtalar Arthrodesis in the Supine Position Indications and Contraindications Preoperative Evaluation and Planning Subtalar Arthrodesis Surgical technique. Postoperative management. Results and complications. Great Toe Arthroscopy Indications and Contraindications Anatomy of the Metatarsophalangeal Joint Preoperative Evaluation and Planning Traction and instrumentation. Arthroscopic portals. Arthroscopy of the Great Toe Surgical technique. Normal arthroscopic examination. Postoperative management. Results and complications. Hallux Rigidus Indications and Contraindications Preoperative Evaluation and Planning Arthroscopic Cheilectomy of the Metatarsophalangeal Joint Postoperative management. Osteochondral Lesions of the Great Toe Preoperative Evaluation and Planning Surgical Treatment Lesser Toe Arthroscopy ENDOSCOPIC PROCEDURES Tendoscopy Flexor Hallucis Longus Tendoscopy Indications and contraindications. Normal anatomy. Preoperative evaluation and planning. Flexor hallucis longus tendon tendoscopy by ankle access. Surgical technique. Flexor hallucis longus tendon tendoscopy by subtalar access. Surgical technique. Peroneal Tendon Tendoscopy Indications and contraindications. Preoperative evaluation and planning. Peroneal tendon tendoscopy. Surgical technique. Postoperative care. Posterior Tibial Tendon Tendoscopy Indications and contraindications. Preoperative evaluation and diagnosis. Posterior tibial tendon tendoscopy. Surgical technique. Postoperative care. Results and complications. Plantar Fascia Release Indications and Contraindications Anatomy Preoperative Evaluation and Planning Signs and symptoms. Endoscopic Portals Endoscopic Release of the Plantar Fascia Surgical technique. Postoperative management. Results. Endoscopic Tarsal Tunnel Release Indications and Contraindications Preoperative Evaluation and Planning Surgical Treatment HINDFOOT ARTHROSCOPY AND ENDOSCOPY IN THE PRONE POSITION Overview Basic Setup Anatomy Portals Joint Distraction Retrocalcaneal Bursitis and the Haglund Deformity Indications and Contraindications Anatomy Preoperative Evaluation and Planning Signs and symptoms. Diagnostic studies. Conservative Treatment Tendoscopy for the Haglund Deformity Positioning, tourniquet, anesthesia, and equipment. Portals. Surgical technique. Postoperative care. Results and complications. Achilles Tendinosis and Paratendinitis Indications and Contraindications Anatomy Preoperative Evaluation and Planning Signs and symptoms. Portals Achilles Tendoscopy Surgical technique. Postoperative care. Results and complications. Posterior Ankle Impingement and Flexor Hallucis Longus Tenosynovitis Overview Indications and Contraindications Preoperative Evaluation and Planning (Video 39-5) Arthroscopic Os Trigonum Excision (See Video 28-5) Surgical technique. Postoperative care. Results and complications. Posterior Arthroscopic Subtalar Arthrodesis (PASTA) Overview Indications and Contraindications Preoperative Evaluation and Planning Surgical Treatment Surgical technique. Postoperative care. Results and complications. Arthroscopic Hindfoot Arthrodesis in the Prone Position Excision of Talocalcaneal Coalition Using Posterior Hindfoot Endoscopy Endoscopic Peroneal Groove Deepening FUTURE TRENDS IN FOOT ARTHROSCOPY Hallux Metatarsophalangeal Joint Arthritis Talonavicular and Calcaneocuboid Arthroscopy Intermetatarsal Neuroma Endoscopy Endoscopic Gastrocnemius Recession Endoscopically Assisted Percutaneous Achilles Tendon Repair COMPLICATIONS OF ANKLE AND FOOT ARTHROSCOPY Incidence Neurovascular Tourniquet Tendon and Ligament Injuries Articular Cartilage Injury Instrument Breakage Fluid Management Complications Wound Complications and Infection How to Avoid Complications References 40. Osteochondral Lesions 40 Osteochondral Lesions OSTEOCHONDRAL LESIONS OF THE TALUS Pathogenesis Incidence Preoperative Evaluation and Classification Treatment Decisions for OLT Surgical Techniques Lavage and Debridement Retrograde Drilling Surgical technique for large cystic lesions with an intact cartilage surface. Primary Repair Surgical technique for acute repair. Local Bone Marrow Cell–Mediated Restorative Techniques Surgical technique for small, chronic, and acute irreparable lesions (Videos 40-1 and 40-2). Transplanted Cell-Mediated Restorative Techniques Particulated cartilage allograft. Autologous chondrocyte implantation. Membrane or gel-associated autologous cell implantation. Surgical technique for large lesions without a cystic component. Reconstruction Techniques Involving Bone Autologous bone grafting. Osteochondral autograft or allograft (Video 40-3). Surgical technique for large lesions with a cystic component (Video 40-4). Results Nonoperative Treatment Debridement Retrograde Drilling Repair Restoration Using Local Marrow Cells Microfracture. Adjuvant treatments for microfracture. Restoration Using Remote or Allograft Cells Autologous chondrocyte implantation. Membrane- or scaffold-based techniques. Particulated cartilage graft. Bone Grafting and Osteochondral Transfer Bone grafting. Osteochondral autograft transfer. Osteochondral allograft. Salvage After Failed Treatment of Osteochondral Lesions Future Directions OSTEOCHONDRAL LESIONS OF THE TIBIAL PLAFOND Etiology and Incidence Preoperative Evaluation and Planning Surgical Treatment Surgical Technique Alternative Treatments Results and Complications OSTEOCHONDRAL LESIONS OF THE FOOT Acknowledgments References PART X. Pediatrics 41. Congenital Foot Deformities 41 Congenital Foot Deformities PRENATAL DEVELOPMENT Embryology Growth and Development Genetics CLUBFOOT (TALIPES EQUINOVARUS) Incidence Etiology Pathologic Anatomy Radiographic Evaluation Conservative Treatment Ponseti Method (Video 41-1) Technique. Maintenance phase. Surgical Treatment Clubfoot Release Surgical technique. Postoperative care. Special Problems Complications Uncorrected or Residual Clubfoot in Older Children METATARSUS ADDUCTUS Evaluation and Classification Conservative Treatment Surgical Treatment Multiple Metatarsal Osteotomies Surgical technique. Postoperative care. Complications. Cuneiform and Cuboid Osteotomies Surgical technique. Postoperative care. FLATFOOT (PES PLANUS) Flexible Flatfoot Radiographic Evaluation Conservative Treatment Surgical Treatment Anterior calcaneal osteotomy. Surgical technique. Additional considerations. Postoperative care. Rigid Flatfoot Tarsal Coalition Calcaneonavicular Coalition Calcaneonavicular coalition resection (Video 41-2). Surgical technique. Talocalcaneal Coalition (Video 41-3) Resection of talocalcaneal coalition. Surgical technique. Postoperative care. Congenital Vertical Talus Correction of Vertical Talus Minimally invasive approach. Surgical technique. Extensive soft tissue release. Surgical technique. Postoperative care. Accessory Navicular TOE ABNORMALITIES Congenital Hallux Varus Polydactyly Syndactyly Macrodactyly Fifth Toe Contracture or Angulation Acknowledgments References PART XI. Trauma 42. Complex Trauma and Soft Tissue Reconstruction for the Foot and Ankle 42 Complex Trauma and Soft Tissue Reconstruction for the Foot and Ankle SOFT TISSUE COMPLICATIONS IN FOOT AND ANKLE SURGERY Elective Surgical Wounds Pressure Wounds Traumatic Wounds Soft Tissue Envelope TEAM APPROACH TO EXTREMITY RECONSTRUCTION THE RECONSTRUCTIVE LADDER Evaluation of the Patient With a Wound Classification of Soft Tissue Injury GENERAL PRINCIPLES OF SOFT TISSUE RECONSTRUCTION Skin Grafts Local Tissue Rearrangement Flaps DEBRIDEMENT Fresh Wounds Chronic Wounds Debridement of a Chronic Wound Surgical technique. TIMING OF RECONSTRUCTION PREPARATION OF THE WOUND BEFORE RECONSTRUCTION Wound Dressing Antibiotic Beads Placing an Antibiotic Bead Pouch Surgical technique. Hyperbaric Oxygen Negative Pressure Therapy Amputation Versus Salvage WOUND CLOSURE SKIN GRAFTING Split-Thickness Skin Grafting Surgical Technique Dressing Application Full-Thickness Skin Grafting Surgical Technique Dressing Application Skin Substitutes Application of Skin Substitutes Over Bone Surgical technique. Skin Graft Aftercare and Long-Term Issues FLAPS Classification of Muscle Flaps Fasciocutaneous Flaps Reverse Sural Flap Indications. Complications of the reverse sural flap. FREE FLAPS Indications for Free Tissue Transfer in the Lower Extremity Trauma and Sepsis Osteomyelitis Timing of Free Tissue Transfer Selection of Tissue for Transplantation Latissimus Dorsi Rectus Abdominis Gracilis Fibula Medial Femoral Condyle Flap Radial Forearm Flap Scapular and Parascapular Flap Anterolateral Thigh Flap Ancillary Techniques to Assist With Flap Reconstruction Postoperative Care Monitoring Clinical Evaluation Direct Vessel Monitoring Circulation Monitoring Metabolic Monitors Flap Failure and Management (Acute) Treatment of Failure (Late) RECONSTRUCTIVE ALGORITHM BY REGION Group A: Closed Fractures Treated by Open Reduction and Internal Fixation Group A1: Inability to Close the Skin Group A2: Postoperative Wound Breakdown Group B: Requirements for Free Flaps for Foot Reconstruction Group B1: Traumatic Large Soft Tissue Loss With Adequate Bone Stock Group B2: Traumatic Loss of Soft Tissue and Bone Group C: Osteomyelitis Group D: Reconstruction for Unstable Soft Tissue TRAUMA AND THE DYSVASCULAR AND DIABETIC FOOT ESTHETIC CONSIDERATIONS AFTER LIMB TRAUMA TISSUE EXPANSION Acknowledgments References 43. Pilon Fractures 43 Pilon Fractures ANATOMY MECHANISM OF INJURY FRACTURE CLASSIFICATION INITIAL EVALUATION Associated Injuries EVOLUTION OF TREATMENT STAGED OPEN REDUCTION AND INTERNAL FIXATION Stage 1: Temporizing Fixation Fibular Fixation Limited Tibial Fixation Single-Stage Tibial Fixation External Fixation Surgical technique. Stage 2: Definitive Fixation Overview Patient Positioning Surgical Approach Posterolateral approach (see Fig. 43-11E–G). Surgical technique. Anteromedial approach (see Figs. 43-11C and D). Surgical technique. Anterolateral approach (see Fig. 43-11A and B). Surgical technique. Posteromedial approach (see Fig. 43-11G–I). Surgical technique. Reduction Tactic Fixation Strategy Wound Closure Postoperative Care EXTERNAL FIXATION Articular Reduction Coupled With Frame Application Articular Reduction Using Limited Incisions and External Fixation (Video 43-1) Surgical technique. Results. Articular Reduction Using Ilizarov Techniques Surgical technique. Results. Frame Application Without Articular Reduction Surgical Technique Postoperative Care Results Summary. PRIMARY ARTHRODESIS Surgical Technique Postoperative Care COMPLICATIONS Wound Problems Deep Infection Failure of Fixation Nonunion Posttraumatic Arthritis Acknowledgments References 44. Ankle Fractures and Dislocations 44 Ankle Fractures and Dislocations ANATOMY CLASSIFICATION RADIOGRAPHIC EVALUATION TREATMENT CONCEPTS Operative Versus Nonoperative Treatment Timing of Surgery Patient Positioning Incisions TREATMENT OF SPECIFIC FRACTURES Fibular Fracture Fixation Type A (Infrasyndesmotic) Fractures Type B (Transsyndesmotic) Fractures (Video 44-1) Type C (Suprasyndesmotic) Fractures Medial Malleolus Fracture Fixation Posterior Malleolus Fractures Techniques for Fixation of the Posterior Malleolus Syndesmotic Injuries Techniques for Fixation of the Syndesmosis (Video 44-2) Deltoid Ligament Injury Techniques for Deltoid Repair ARTHROSCOPIC EVALUATION OF ANKLE FRACTURES OPEN ANKLE FRACTURES AND DISLOCATIONS ANKLE FRACTURES IN DIABETIC PATIENTS POSTOPERATIVE MANAGEMENT OF ANKLE FRACTURES COMPLICATIONS Malunion Nonunions Infection/Wound Complications Posttraumatic Arthritis Acknowledgments References 45. Fractures of the Calcaneus 45 Fractures of the Calcaneus EPIDEMIOLOGY PATHOANATOMY INTRAARTICULAR FRACTURES Mechanism of Injury Clinical Evaluation Injury to the Soft Tissue Envelope Compartment syndrome. Skin blisters. Open Fractures Associated Injuries Radiologic Evaluation Plain Radiography Computed Tomography Classification Classifications Based on Plain Radiography Classifications Based on Computed Tomography Scanning Treatment: A Historical Review Nonoperative Treatment Operative Versus Nonoperative Treatment of Displaced Fractures Operative Treatment for Displaced Intraarticular Fractures Preoperative Planning Extensile Lateral Approach Less Invasive Approaches Percutaneous Reduction and Fixation Limited Open Reduction With the Sinus Tarsi Approach Tongue-Type Fractures Primary Arthrodesis for Type IV Fractures Extensile Lateral Approach (Sanders) Surgical technique. General considerations and patient positioning. Incision and approach. Mobilization of the fragments. Reduction of the articular surface and anterior process. Definitive fixation. Assessing the peroneal tendons. Wound closure. Postoperative care. Limited Open Reduction With Sinus Tarsi Approach Surgical technique. Postoperative care. Percutaneous Modified Essex-Lopresti Technique Surgical technique (after Tornetta) (Video 45-2). Postoperative care. FRACTURE-DISLOCATIONS OF THE CALCANEUS Mechanism of Injury and Pathoanatomy Clinical and Radiographic Evaluation Treatment TRANSCALCANEAL TALONAVICULAR DISLOCATIONS FRACTURES OF THE SUSTENTACULUM TALI ANTERIOR PROCESS FRACTURES Treatment EXTRAARTICULAR FRACTURES Tuberosity (Avulsion) Fractures Clinical Evaluation Radiologic Evaluation Treatment Fractures of the Medial Process of the Tuberosity Extraarticular Body Fractures Mechanism of Injury Treatment POSTOPERATIVE COMPLICATIONS Wound Complications Posttraumatic Arthritis Calcaneal Malunion Correction of Calcaneal Malunion (Sanders) Surgical technique. Peroneal Tendon Problems Tendinitis and Stenosis Tendon Dislocation Neurologic Complications Cutaneous Nerve Injury Nerve Entrapment Complex Regional Pain Syndrome Ankle Pain Heel Pad Pain and Exostoses Acknowledgments References 46. Talus Fractures and Peritalar Dislocations 46 Talus Fractures and Peritalar Dislocations ANATOMY Skeletal Talar Body Talar Neck Talar Head Vascular Extraosseous Arterial Supply Posterior tibial artery. Anterior tibial artery. Peroneal artery. Artery of the tarsal canal. Artery of the tarsal sinus. Intraosseous Arterial Supply Talar head. Talar body. Intraosseous anastomoses. FRACTURES OF THE TALAR NECK Anatomy Mechanism of Injury Classification Clinical Evaluation Radiologic Evaluation Treatment Type I Fractures Authors' preferred method of treatment. Results. Type II Fractures Initial management. Definitive treatment. Authors' preferred method of treatment. Postoperative care. Results. Type III Fractures Urgent management. Definitive treatment. Authors' preferred method of treatment. Postoperative care. Results. Type IV Fractures Open Talar Neck Fractures TOTAL DISLOCATION OF THE TALUS Reimplantation Resection and Fusion Authors’ Preferred Method of Treatment SUBTOTAL DISLOCATION OF THE TALUS (SUBTALAR OR PERITALAR) History and Classification Anatomy Mechanism of Injury Clinical Evaluation Radiographic Evaluation Treatment and Results FRACTURES OF THE TALAR BODY Mechanism of Injury Classification Clinical and Radiographic Evaluation Treatment Nonoperative Treatment Surgical Treatment Authors’ preferred method of treatment. Postoperative Treatment Results COMPLICATIONS ASSOCIATED WITH FRACTURES OF THE TALAR NECK AND BODY Posttraumatic Arthritis Avascular Necrosis Diagnosis Treatment Skin Necrosis Infection and Osteomyelitis Malunion of the Talar Neck Delayed Union and Nonunion of the Talar Neck Arthrofibrosis FRACTURES OF THE TALAR HEAD Incidence Mechanism of Injury and Classification Clinical Evaluation Radiographic Evaluation Treatment Results FRACTURES OF THE POSTERIOR PROCESS Anatomy Posterior Process Os Trigonum Mechanism of Injury Clinical Evaluation Radiologic Evaluation Treatment Authors’ Preferred Method of Treatment Results FRACTURES OF THE LATERAL PROCESS Incidence Anatomy Mechanism of Injury Clinical Evaluation Radiographic Evaluation Classification Treatment Author's Preferred Method of Treatment Results SALVAGE PROCEDURES Arthrodesis: General Principles Ankle Arthrodesis Talectomy Blair Tibiotalar Fusion Surgical Technique of Modified Blair Fusion77 Postoperative Care Results Talar Prosthetic Replacement Tibiocalcaneal Fusion (Video 25-10) Tibiotalocalcaneal and Pantalar Fusion Intramedullary Rod Stabilization (Videos 25-6 and 25-7) Plate Fusions (Videos 25-8 and 25-9) Anterior approach. Surgical technique.79 Postoperative care. Large-Fragment Cancellous Screw Fixation Surgical technique.216 Postoperative care. Extraarticular Fusion Surgical technique.217 Postoperative care. Free Vascularized Fibula Authors' Preferred Method of Treatment Acknowledgments References 47. Fractures and Dislocations of the Midfoot and Forefoot 47 Fractures and Dislocations of the Midfoot and Forefoot THE TARSAL NAVICULAR Anatomy NAVICULAR FRACTURES Avulsion Fractures Nonoperative Management Operative Management Navicular Tuberosity Fractures Nonoperative Management Operative Management Navicular Body Fractures Nonoperative Management Operative Management Results. Complications. Stress Fractures of the Tarsal Navicular Mechanism of Injury Radiographic Evaluation Treatment and Results Navicular Dislocation CUBOID AND CUNEIFORM BONES Cuboid Fractures Avulsion Fractures Treatment. Compression Fractures Treatment. Stress Fractures Treatment. Cuneiform Fractures Avulsion Fractures Mechanism of injury. Treatment. Crush Injuries Mechanism of injury. Treatment. Cuneocuboid Dislocations Cuneiform Dislocation Cuboid Bone LISFRANC JOINT INJURIES History Anatomy Skeletal Elements Tarsometatarsal joints. Intermetatarsal and intertarsal joints. Capsuloligamentous Restraints Joint capsules. Ligaments. Associated Structures Dorsalis pedis artery and deep peroneal nerve. Anterior tibial tendon and peroneus longus tendon. Interossei and plantar fascia. Mechanism of Injury Radiographic Evaluation Normal Anatomy Positive Findings Stress and weight-bearing views. Computed tomography. Magnetic resonance image (MRI). Classification Clinical Evaluation Treatment Surgical Approach Definitive Fixation (Videos 47-1 through 47-3) Postsurgical Care Prognosis and Outcomes Complications Posttraumatic arthritis. Deformity. Vascular compromise. Compartment syndrome. METATARSAL FRACTURES Anatomy Mechanism of Injury Metatarsal Base Fractures (Excluding Fifth) Metatarsal Shaft Fractures (Video 47-4) Metatarsal Neck Fractures Metatarsal Head Fractures Stress Fractures of the Metatarsal Fractures of the Fifth Metatarsal Base Anatomy Tuberosity Avulsion Fractures of the Fifth Metatarsal History and mechanism of injury. Treatment and results. Stress Fractures of the Fifth Metatarsal History and mechanism of injury. Treatment and results. METATARSOPHALANGEAL JOINT DISLOCATIONS Anatomy Hallux Metatarsophalangeal Sprains and Dislocations Mechanism of Injury Classification Clinical Evaluation Treatment Results Lesser Toe Metatarsophalangeal Dislocations Mechanism of Injury Clinical Evaluation Treatment Results PHALANGEAL BONES Anatomy Mechanism of Injury Clinical Evaluation Treatment Hallucal Fractures Nonoperative management. Operative management. Lesser Toe Fractures Nonoperative management. Operative management. INTERPHALANGEAL JOINT DISLOCATIONS Anatomy Mechanism of Injury Classification Clinical Evaluation Treatment SESAMOID BONES Anatomy Fractured Sesamoids Mechanism of Injury Clinical Evaluation Treatment Nonoperative management. Operative management. Dislocated Sesamoids CRUSH INJURY Acknowledgments References Index Confidence is ClinicalKey Confidence is ClinicalKey
نظرات کاربران
کتاب های تصادفی
دانلود کتاب The Art of War: A Hobby Enthusiasts Guide to Flames of War Painting and Modeling Issue 1
دانلود کتاب JavaScript. Профессиональные приемы программирования CODE
دانلود کتاب The Ecology of Marine Fishes: California and Adjacent Waters
