The Foot: From Evaluation to Surgical Correction

Description

This superbly illustrated book guides the reader on a rational pathway from anamnesis and clinical examination through radiological screening to the appropriate surgical solution for a wide range of foot conditions. Proposed treatments and follow-up results are presented in detail with the aid of intra- and postoperative photographs and radiographs. A key feature is the focus on systematic description, and the treatment-related chapters include numerous references to earlier parts of the book in order to clearly link the preoperative evaluation to the treatment. It is particular to the surgical correction of foot and ankle pathology that the treatment is nearly always "composite" or complex, in that it entails several separate actions. Thus, surgical correction often has one or more structural components (e.g., osteotomy, arthrodesis) and one or more functional or motor components. The book aims to explain the rationale and effect of every one of these components. The new edition includes updated guidance on clinical examination, a series of cases demonstrating the composite approach to complex reconstructions, and detailed coverage of the treatment of diabetic arthropathy Preface to the Second Edition Preface to the First Edition Contents 1: Introduction 1.1 General Considerations 1.2 Anamnesis 1.2.1 Subjective Disorders 1.2.1.1 Pain 1.2.1.2 Instability 1.2.1.3 Impaired Function 1.2.2 Relevant Parameters 2: Clinical Examination 2.1 Observation 2.1.1 Statics 2.1.1.1 Pelvis - Lower Leg 2.1.1.2 Hindfoot and Midfoot 2.1.1.3 Footprint 2.1.1.4 Tiptoe 2.1.1.5 Forefoot 2.1.1.6 Heels Standing 2.1.2 Nonstatic Observation 2.1.2.1 Unloaded Alignment 2.1.2.2 Foot Sole 2.2 Palpation and Joint Mobility 2.2.1 Heel Cord 2.2.2 Heel 2.2.3 Plantar Fascia 2.2.4 Upper Ankle Joint 2.2.4.1 Lateral Ankle 2.2.4.2 Medial Ankle 2.2.4.3 Posterior Ankle 2.2.5 Lower Ankle Joint 2.2.5.1 Motion 2.2.5.2 Lateral Process of the Talus 2.2.5.3 Sustentaculum Tali 2.2.5.4 Talo-Navicular Joint 2.2.5.5 Posterior Subtalar Joint Facet 2.2.5.6 Posterior Tibial Tendon and Navicular Bone 2.2.6 Processus Anterior Calcanei 2.2.7 Calcaneo-Cuboidal Joint 2.2.8 Fibular Muscles and Tendons 2.2.9 Naviculo-Cuneiform Joints 2.2.10 Second and Third Tarso-Metatarsal Joints 2.2.11 Fourth and Fifth Tarso-Metatarsal Joints 2.2.12 First Tarso-Metatarsal Joint 2.2.13 Second and Third Metatarsal Heads 2.2.14 Fourth Metatarsal Head 2.2.15 Lesser Intermetatarsal Plantar Space 2.2.16 Metatarso-Phalangeal Joints 2.2.16.1 First Ray 2.2.16.2 Lesser Rays 2.2.17 Sesamoids of the First Ray 2.2.18 Toes 2.2.19 Sensitivity 2.3 Active Joint Mobility and Functional Exam 2.3.1 Active Joint Mobility 2.3.1.1 Upper Ankle Joint 2.3.1.2 Lower Ankle Joint 2.3.2 Functional Exam 2.3.2.1 Walking Tiptoe 2.3.2.2 Walking on the Heels 2.3.2.3 Hopping on One Leg 2.3.2.4 Static Tiptoe 3: Radiological Screening 3.1 Conventional Radiographs 3.1.1 Hindfoot 3.1.1.1 Antero-Posterior View (Frontal Plane) Hindfoot Varus Hindfoot Valgus 3.1.1.2 Lateral View (Sagittal Plane) Arthrosis of the upper ankle joint 3.1.2 Foot 3.1.2.1 Antero-Posterior (Dorso-Plantar) View (Horizontal Plane) Pes Abductus Unstable First Ray Splay Foot Index Metatarsus Minus Index Metatarsus Plus 3.1.2.2 Lateral View (Sagittal Plane) 3.1.3 Special Incidences 3.1.3.1 Oblique 3.1.3.2 Brodén View 3.1.3.3 Forefoot Axial 3.1.3.4 Stress Views of TMT Joints 3.2 Computed Tomography 3.3 Magnetic Resonance Imaging 5: Surgical Treatment of Traumatic Lesions 5.1 Healing of Traumatized Biological Tissues 5.1.1 Bone 5.1.2 Cartilage 5.1.3 Granulation Tissue 5.2 Tendon Ruptures 5.2.1 Achilles Tendon Rupture 5.2.2 Anterior Tibial Tendon Rupture 5.2.3 Posterior Tibial Tendon Rupture 5.3 Fractures 5.3.1 Ankle Fractures 5.3.1.1 Malleolar Fractures 5.3.1.2 Rupture of the Distal Tibio-Fibular Syndesmosis 5.3.1.3 Pilon Fractures 5.3.2 Fractures of the Talus 5.3.2.1 Peripheral Fractures 5.3.2.2 Central Fractures 5.3.2.3 Approaches Medial Approach Antero-Lateral Approach Postero-Lateral Approach 5.3.3 Calcaneus Fractures 5.3.4 Fractures of the Navicular Bone 5.3.5 Tarso-Metatarsal Fractures 5.3.6 Metatarsal Fractures 5.3.7 Fractures of the Sesamoid Bones 6: Operative Techniques 6.1 Positioning of the Patient 6.2 Skin and Subcutaneous Handling 6.2.1 Instruments 6.2.2 Skin Plasty 6.2.2.1 Unidirectional Lengthening 6.2.2.2 Local Flaps 6.3 Surgical Approaches 6.3.1 Upper Ankle Joint 6.3.1.1 Postero-Lateral 6.3.1.2 Anterior 6.3.1.3 Antero-Lateral 6.3.1.4 Postero-Medial 6.3.2 Fibula 6.3.3 Medial Utility 6.3.4 Lateral Hindfoot 6.3.5 Lateral Midfoot 6.3.6 Medial Tarso-Metatarsus 6.3.7 Central Tarso-Metatarsus 6.3.8 Lateral Tarso-Metatarsus 6.3.9 Central Metatarsus 6.3.10 Fourth Metatarsus 6.3.11 Fifth Metatarsus 6.3.12 Lesser Toes 6.4 Post-operative Care 6.5 Bone and Joint Reconstruction and Alignment 6.5.1 Supramalleolar Osteotomy 6.5.2 Lateral Malleolus Osteotomy 6.5.3 Upper Ankle Fusion 6.5.4 Osteochondroplasty of the Talus 6.5.5 Cheilectomy of the Upper Ankle Joint 6.5.6 Cheilectomy of the Lower Ankle Joint 6.5.7 Reorientation Osteotomy of the Tuber Calcanei 6.5.8 Reorientation Arthrodesis of the Subtalar Joint 6.5.9 Tibio-Talo-Calcaneal Arthrodesis 6.5.10 Posterior Calcaneal Ostectomy 6.5.11 Arthrolysis of the Talo-Calcaneo-Navicular Joint 6.5.12 Central Talus Osteotomy 6.5.13 Central Calcaneus Osteotomy 6.5.14 Triple Arthrodesis 6.5.15 Naviculo-Cuneiform Arthrodesis 6.5.16 Talo-Metatarsal Arthrodesis 6.5.17 Fusion of the First Tarsometatarsal Joint and First Intermetatarsal Space (E137-138)(O385) 6.5.18 Second and Third Tarsometatarsal Arthrodesis 6.5.19 Fourth and Fifth Tarsometatarsal Arthroplasty 6.5.20 Diaphyseal Osteotomy of the First Metatarsus 6.5.21 Diaphyseal Osteotomy of the Second and Third Metatarsus 6.5.22 Diaphyseal Osteotomy of the Fourth Metatarsus 6.5.23 Proximal Metaphyseal Osteotomy of the Second, Third and Fourth Metatarsus 6.5.24 Diaphyseal Adduction Osteotomy of the Fifth Metatarsus 6.5.25 Intracapital Extension Osteotomy of the First Metatarsus (Watermann) [119] 6.5.26 Intracapital Extension Osteotomy of the Second and Third Metatarsus (Gauthier) [69] (O426) 6.5.27 First Metatarso-Sesamoido-Phalangeal Joint Fusion 6.5.28 Osteotomy of the First Phalanx of the Big Toe 6.5.29 Shortening Osteotomy of the First Phalanx of the Lesser Rays 6.5.30 Proximal Interphalangeal Fusion 6.5.31 Distal Interphalangeal Fusion 6.6 Ligamentous Reconstruction of the Ligaments About the Ankle Joints 6.6.1 Syndesmosis 6.6.2 Anterior Fibulo-Talar Ligament 6.6.2.1 Repair 6.6.2.2 Plasty 6.6.3 Cervical Talocalcaneal Ligament Plasty 6.7 Tendinous Balance Reconstruction 6.7.1 Heel Cord Lengthening 6.7.2 Gastrocnemius Fasciotomy 6.7.3 Gastrocnemius Tenotomy 6.7.4 Heel Cord Plasty 6.7.5 Reconstruction of Fibular Tendons 6.7.6 Posterior Tibial Tendon Repair 6.7.7 Posterior Tibial Tendon transfer onto the Dorsum of the Foot 6.7.8 Long Toe Extensors Transfer on the Dorsum of the Foot 6.7.9 Fibularis Longus Tendon Transfer onto Fibularis Brevis 6.7.10 Flexor Hallucis Longus Tendon Transfer onto Fibularis Brevis 6.7.11 Flexor Hallucis Longus Tendon Transfer onto the Basis of the First Metatarsus 6.7.12 Flexor Hallucis Longus Tendon Transfer on the First Phalanx 6.7.13 First Dorsal Interosseus Transfer on the First Phalanx of the Hallux 6.7.14 Flexor Digitorum Longus Tendon Transfer on the First Phalanx 6.7.15 Extensor Digitorum Minimi Transfer on the Abductor Digiti Quinti 6.8 Intermetatarsal Neurectomy (E143 R191) 6.9 Stretching 6.10 Orthoses 7: Complex Reconstructions 7.1 Pes Cavus 7.1.1 Compensated Pes Cavus Varus 7.1.2 Decompensated Pes Cavus Varus 7.1.2.1 Single Step Correction 7.1.2.2 Progressive Correction 7.2 Pes Planus 7.2.1 Flexible Flat Foot 7.2.2 Rigid Flat Foot 7.3 Surgical Reconstructions of Diabetic Arthropathies 7.3.1 The Pathology 7.3.2 Midfoot Diabetic Arthropathy 7.3.3 Hindfoot Diabetic Arthropathy 7.4 Revisions After Failed Surgical Treatment 7.4.1 Revisions After Failed Arthroplasty 7.4.1.1 After Total Ankle Replacement 7.4.1.2 After MTP1 Arthroplasty 7.4.2 Malunited Osteo-Articular Reconstructions 7.4.2.1 Post-traumatic Malunions 7.4.2.2 Malunited Arhrodeses 7.5 Amputations 7.5.1 Transphalangeal Amputation 7.5.2 Transmetatarsal Amputation 7.5.3 Tarso-Metatarsal Amputation (Lisfranc) 7.5.4 Midfoot Amputation (Chopart) 7.5.5 Hindfoot Amputations 7.5.6 Single Ray Amputation References Acknowledgements and Post-face Index