Clinics in podiatric medicine and surgery
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Heel pain is a condition that is generally more common in the adult population. However, it is a condition that the foot and ankle specialist must be prepared to treat in pediatric patients. ⋯ The presenting signs and symptoms, as well as proper workup and treatment are discussed. Two case reports of unusual pediatric calcaneal fractures are also presented.
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Clin Podiatr Med Surg · Apr 2019
ReviewSinus Tarsi Approach with Subcutaneously Delivered Plate Fixation for Displaced Intra-Articular Calcaneal Fractures.
Displaced intra-articular calcaneal fractures can be treated with open reduction and internal fixation through various methods, including the extensile lateral approach, sinus tarsi approach, percutaneous reduction and fixation, external fixation, and calcaneoplasty. Although the gold standard is the extensile lateral approach, this method has significant wound-healing complications associated with it. Literature shows that the reduction achieved through minimally invasive techniques is equal to that achieved with the extensile lateral approach, while reducing the amount of postoperative complications. This article outlines a technique that uses the sinus tarsi approach with subcutaneous plate fixation.
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Clin Podiatr Med Surg · Jan 2019
ReviewPerioperative Cardiac Considerations in the Surgical Patient.
The ability to identify and guide evaluation of the patient with cardiac disease represents a necessary skill for success in surgery of the foot and ankle. Common risk factors, such as diabetes and peripheral arterial disease, are encountered in podiatric practice. ⋯ Identification of risk factors, assessment of functional capacity, and appropriate work-up mitigate any untoward cardiac events surrounding surgery. This optimization results from appropriate medical and interventional treatment plans directed at minimizing or eliminating identified risks factors.
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Treating patients with kidney disease can be both a difficult and a complex process. Understanding how to care for patients who have kidney disease is essential for lowering perioperative as well as periprocedural morbidity and mortality. The primary aim in renal evaluation and care is to control and mitigate factors that may result in acute kidney injury (AKI) and/or cause further decline in renal function. It is essential for the foot and ankle specialist to recognize patients who are predisposed to developing or already have impairment of renal function.
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Clin Podiatr Med Surg · Apr 2019
ReviewPrimary or Secondary Subtalar Arthrodesis and Revision of Calcaneal Nonunion with Minimally Invasive Rigid Internal Nail Fixation for Treatment of Displaced Intra-Articular Calcaneal Fractures.
Primary or secondary subtalar joint arthrodesis after displaced intra-articular calcaneal fractures makes use of talocalcaneal large-diameter screw fixation after an eventual correction of geometric hindfoot deformity. Despite this procedure usually having a successful functional outcome, potential complications occur, including nonunion and malalignment, with an unknown rate of loss of correction or implant migration during the healing period. Angular stable fixation of the subtalar joint arthrodesis with an interlocking nail applied in a minimally invasive technique affords maintenance of the hindfoot position until osseous healing occurs. The key steps of the surgical technique are described.