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Joint-Preserving Osteotomies for Malunited Foot & Ankle Fractures, An Issue of Foot and Ankle Clinics of North America, E-Book

Joint-Preserving Osteotomies for Malunited Foot & Ankle Fractures, An Issue of Foot and Ankle Clinics of North America, E-Book

Stefan Rammelt

(2016)

Additional Information

Book Details

Abstract

This issue will include articles on Supramalleolar osteotomies for posttraumatic malalignment of the distal tibia, Intra-articular osteotomies for malunited tibial pilon fractures , Secondary reconstruction for malunions and nonunions of the talar body, Corrective osteotomies for malunited tongue type calcaneal fractures, Joint-sparing corrections of malunited Chopart joint injuries and many more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Joint-Preserving Osteotomies for Malunited Foot & Ankle Fractures \r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Preface: Anatomical Reconstruction for Malunited Foot and Ankle Fractures\r vii
Supramalleolar Osteotomies for Posttraumatic Malalignment of the Distal Tibia\r vii
The Use of Tibial Osteotomy (Ankle Plafondplasty) for Joint Preservation of Ankle Deformity and Early Arthritis\r vii
Extraarticular Supramalleolar Osteotomy for Managing Varus Ankle Osteoarthritis, Alternatives for Osteotomy: How and Why?\r vii
Corrective Osteotomies for Malunited Malleolar Fractures\r viii
Treatment of Nonunions After Malleolar Fractures\r viii
Intra-articular Osteotomy for Correction of Malunions and Nonunions of the Tibial Pilon\r viii
Osteotomies of the Talar Neck for Posttraumatic Malalignment\r viii
Secondary Reconstruction for Malunions and Nonunions of the Talar Body\r ix
Joint-Preserving Osteotomies for Malaligned Intraarticular Calcaneal Fractures\r ix
Corrective Osteotomies for Malunited Tongue-Type Calcaneal Fractures\r ix
Corrective Osteotomies for Malunited Extra-Articular Calcaneal Fractures\r ix
Joint-Sparing Corrections of Malunited Chopart Joint Injuries\r x
Joint-sparing Corrections in Malunited Lisfranc Joint Injuries\r x
FOOT AND ANKLE CLINICS\r xi
FORTHCOMING ISSUES xi
June 2016 xi
September 2016 xi
December 2016 xi
RECENT ISSUES xi
December 2015 xi
September 2015 xi
June 2015 xi
Preface:Anatomical \rReconstruction for Malunited Foot and Ankle Fractures xiii
Supramalleolar Osteotomies for Posttraumatic Malalignment of the Distal Tibia 1
Key points 1
INTRODUCTION: NATURE OF THE PROBLEM 1
Biomechanics 2
Indications and Contraindication 2
Overcorrection 2
Concomitant Procedures 3
Lateral-Closing Versus Medial-Opening Supramalleolar Osteotomies of the Tibia 4
SURGICAL TECHNIQUE FOR LATERAL-CLOSING SUPRAMALLEOLAR OSTEOTOMIES OF THE TIBIA 4
Preoperative Planning 4
Preparation and Patient Positioning 6
Surgical Approach 6
Surgical Procedure 7
Step one 7
Step two 7
Step three 7
Step four 7
Immediate Postoperative Care 7
Rehabilitation and Recovery 8
SURGICAL TECHNIQUE FOR MEDIAL-OPENING SUPRAMALLEOLAR OSTEOTOMIES OF THE TIBIA 8
Preoperative Planning 8
Preparation and Patient Positioning 8
Surgical Approach 8
Surgical Procedure 8
Step one 8
Step two 8
Step three 8
Step four 9
Step five 9
Immediate Postoperative Care 9
Rehabilitation and Recovery 9
SURGICAL TECHNIQUE FOR MEDIAL-CLOSING SUPRAMALLEOLAR OSTEOTOMIES OF THE TIBIA 10
Alternative Surgical Techniques 10
Complications 10
CLINICAL RESULTS IN THE LITERATURE 12
SUMMARY 12
REFERENCES 12
The Use of Tibial Osteotomy (Ankle Plafondplasty) for Joint Preservation of Ankle Deformity and Early Arthritis 15
Key points 15
INTRODUCTION 15
PATIENT ASSESSMENT 18
OPERATIVE TECHNIQUE 21
SUMMARY 24
REFERENCES 24
Extraarticular Supramalleolar Osteotomy for Managing Varus Ankle Osteoarthritis, Alternatives for Osteotomy 27
Key points 27
INTRODUCTION 27
PREOPERATIVE PLANNING FOR DISTAL TIBIAL OBLIQUE OSTEOTOMY 29
Assessment of Mortise Widening 29
Assessment of the Medial Translation of the Talus 29
SURGICAL TECHNIQUE OF DISTAL TIBIAL OBLIQUE OSTEOTOMY 30
Complications 31
Necessity of Lateral Ligament Reconstruction 31
RESULTS OF DISTAL TIBIAL OBLIQUE OSTEOTOMY 32
Difference of Ankle Geometry After Distal Tibial Oblique Osteotomy Compared with Supramalleolar Osteotomy 33
SUMMARY 33
REFERENCES 34
Corrective Osteotomies for Malunited Malleolar Fractures 37
Key points 37
INTRODUCTION: NATURE OF THE PROBLEM 37
OPERATIVE TECHNIQUE 39
PREOPERATIVE PLANNING 41
PREPARATION AND PATIENT POSITIONING 41
SURGICAL APPROACHES 41
Medial Malleolus 42
Lateral Malleolus and Small Posterior Malleolus 42
Larger Posterior Malleolus and Posterior Tibial Fragment (Posteromedial Corner) 42
OPERATIVE PROCEDURE 42
Step 1: Medial Malleolus 42
Step 2: Lateral Malleolus 43
Step 3: Posterior Malleolus and Dorsomedial Corner 43
Immediate Postoperative Care 44
Rehabilitation and Recovery 44
Clinical Results in the Literature 45
SUMMARY 47
REFERENCES 47
Treatment of Nonunions After Malleolar Fractures 49
Key points 49
INTRODUCTION: NATURE OF THE PROBLEM 49
PATHOPHYSIOLOGY OF NONUNION 50
SURGICAL TECHNIQUE 51
Evaluation 51
Preoperative Planning 53
Preparation and Patient Positioning 53
Surgical Approach 54
Surgical Procedure: Medial Malleolar Nonunion 54
Surgical Procedure: Lateral Malleolar Nonunion 55
IMMEDIATE POSTOPERATIVE CARE, REHABILITATION, AND RECOVERY 58
SPECIAL CONSIDERATIONS: BONE GRAFTING 58
SPECIAL CONSIDERATIONS: BONE STIMULATION 59
RESULTS AND OUTCOMES 59
SUMMARY 60
SUPPLEMENTARY DATA 60
REFERENCES 60
Intra-articular Osteotomy for Correction of Malunions and Nonunions of the Tibial Pilon 63
Key points 63
INTRODUCTION 63
INDICATIONS/CONTRAINDICATIONS 64
SURGICAL TECHNIQUE 65
Preoperative Planning 65
Surgical Approaches and Patient Positioning 66
SURGICAL PROCEDURES 66
Anterior Approach 66
Medial Malleolar Osteotomy 69
Supramalleolar Deformity 69
Posterior Approach 70
Postoperative Care 72
CLINICAL RESULTS IN THE LITERATURE 72
SUMMARY 74
REFERENCES 75
Osteotomies of the Talar Neck for Posttraumatic Malalignment 77
Key points 77
INTRODUCTION 77
POSTTRAUMATIC TALAR NECK MALALIGNMENT 79
INDICATIONS/CONTRAINDICATIONS 79
PREOPERATIVE PLANNING 79
Clinical Examination 79
Radiographic Evaluation 82
SURGICAL TECHNIQUE 82
Anesthesia and Patient Positioning 82
Surgical Procedure 82
Aftercare 85
SECONDARY SURGERY IN PATIENTS WITH MALUNITED TALAR NECK FRACTURE 86
Salvage Procedures 86
Secondary Anatomic Reconstruction 87
RESULTS 90
SUMMARY 90
REFERENCES 91
Secondary Reconstruction for Malunions and Nonunions of the Talar Body 95
Key points 95
INTRODUCTION 95
INDICATIONS/CONTRAINDICATIONS 96
SURGICAL TECHNIQUE 96
Preoperative Planning 96
Surgical Approaches and Patient Positioning 98
SURGICAL PROCEDURES 100
Anterior and Central Talar Body 100
Lateral Talar Process Malunions 103
Posterior Talar Body and Posterior Talar Process 103
Immediate Postoperative Care 104
Rehabilitation and Recovery 104
Clinical Results in the Literature 104
SUMMARY 107
REFERENCES 107
Joint-Preserving Osteotomies for Malaligned Intraarticular Calcaneal Fractures 111
Key points 111
OSTEOTOMY IN CALCANEAL FRACTURES 111
General Treatment Goals 118
Treatment Details 118
Conservative initial treatment 118
Nonanatomic open reduction with fixation 119
Massive injury with anatomic open reduction 120
SUMMARY 120
REFERENCES 121
Corrective Osteotomies for Malunited Tongue-Type Calcaneal Fractures 123
Key points 123
INTRODUCTION 123
INDICATIONS FOR CORRECTIVE OSTEOTOMY OF TONGUE-TYPE FRACTURES 124
CALCANEAL MALUNION CLASSIFICATIONS 125
PREOPERATIVE PLANNING 125
Clinical Evaluation 125
Radiographic Evaluation 126
Patient Positioning 128
Surgical Approach 128
SURGICAL PROCEDURE 129
Removal of Hardware (Revision Surgery) 130
Excision of the Lateral Wall 130
Osteotomy 131
POSTOPERATIVE CARE 132
RESULTS 132
SUMMARY 133
REFERENCES 133
Corrective Osteotomies for Malunited Extra-Articular Calcaneal Fractures 135
Key points 135
INTRODUCTION 135
PATHOLOGY AND DEFORMITY EVALUATION 136
CLASSIFICATION 136
Indications and Preoperative Evaluation 137
Imaging 137
TREATMENT 137
Conservative Treatment 137
OPERATIVE CARE 138
Lateral Wall Exostectomy 138
Technique 138
Excessive Plantar Bone 139
Posterior Tuberosity Osteotomy 141
Lateral Technique (Smaller Exostoses) 141
Posterior Technique (Larger Exostoses) 141
Postoperative Care 142
Lateral Calcaneal Osteotomy 143
Technique 143
Postoperative Care 143
RESULTS 144
SUMMARY 144
REFERENCES 144
Joint-Sparing Corrections of Malunited Chopart Joint Injuries 147
Key points 147
INTRODUCTION 147
ANATOMY AND PATHOMECHANICS OF ACUTE INJURIES 148
PATHOANATOMY OF POSTTRAUMATIC DEFORMITIES 148
PRINCIPLES OF TREATMENT 149
INDICATIONS AND CONTRAINDICATIONS 150
PATIENT ASSESSMENT AND PREOPERATIVE PLANNING 151
SURGICAL APPROACHES 153
Correction of a Type I Deformity 156
Correction of a Type II Deformity 157
Correction of a Type III Deformity 157
IMMEDIATE POSTOPERATIVE CARE AND REHABILITATION 157
CLINICAL RESULTS FROM THE LITERATURE 158
SUMMARY 158
REFERENCES 159
Joint-sparing Corrections in Malunited Lisfranc Joint Injuries 161
Key points 161
INTRODUCTION 161
PATIENT ASSESSMENT 162
LISFRANC JOINT MALALIGNMENT 162
Tarsometatarsal Bossing and Metatarsalgia 163
PREOPERATIVE IMAGING 164
Decision Making 164
CONSERVATIVE TREATMENT OF LISFRANC MALUNION 164
SURGICAL TREATMENT 166
Patient Warning 166
Patient Position and Incision 167
SURGICAL NEOLIGAMENTPLASTY 168
TECHNIQUE 168
Bone Tunnels 168
GRAFT 170
Joint Stabilization 170
Postoperative Considerations 171
NONRIGID (ENDOBUTTON) STABILIZATION 171
TECHNIQUE 171
Dorsal Plating Without Transarticular Screws 171
TECHNIQUE 172
Reduction 172
Fixation 173
Postoperative Care 173
CLINICAL RESULTS IN THE LITERATURE 174
SUMMARY 174
REFERENCES 175
Index 177