Foot and ankle clinics
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Metatarsal fractures are those most frequently encountered in the foot. More than half of these are of the 5th metatarsal. ⋯ Distal fractures rarely require fixation, even when displacement is wide. Cases of established nonunion or refracture require fixation.
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The paralytic drop foot represents a challenging problem for even the most experienced orthopedic surgeon. Careful patient selection, thorough preoperative examination and planning, and application of tendon transfer biomechanical and physiologic principles outlined in this article can lead to successful results, either through a posterior tibialis tendon transfer, Bridle transfer, or variations on these procedures. Achilles lengthening or gastrocnemius recession may also be needed at the time of tendon transfer.
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This article reviews the basics and evidence base thus far on syndesmosis injuries, focusing on its management in the elite sporting population. A syndesmosis injury or "high ankle sprain" is a significant injury, especially in the elite athlete. ⋯ A high index of suspicion and an understanding of the mechanism of injury is required to ensure an early diagnosis. Incomplete/inaccurate reduction leads to a poor outcome.
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Foot and ankle clinics · Jun 2013
ReviewTibialis posterior tendon and deltoid and spring ligament injuries in the elite athlete.
The tibialis posterior tendon and the spring and deltoid ligament complexes combine to provide dynamic and passive stabilization on the medial side of the ankle and hindfoot. Some of the injuries will involve acute injury to previous healthy structures, but many will develop insidiously. The clinician must be aware of new treatment strategies and the level of accompanying scientific evidence regarding injuries sustained by athletes in these areas, while acknowledging that more traditional management applied to nonathletic patients is still likely to be appropriate in the setting of treatment for elite athletes.
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Foot and ankle clinics · Dec 2012
Review Comparative StudyAnkle arthrodesis versus total ankle replacement: how do I decide?
Taking into account numerous individual criteria, the correct indication substantially influences the outcome of patients with end-stage ankle arthritis treated by ankle arthrodesis or total ankle replacement. The purpose of this report is to assist the foot and ankle surgeon or orthopedic surgeon involved in choosing ankle arthrodesis or total ankle replacement in decision-making. Balancing the criteria that are discussed in consideration of the recent relevant literature and evidence available, the surgeon is directed to the correct individual decision.