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Lisfranc injury is a tarsometatarsal fracture dislocation characterized by traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal Easily missed on radiographs May take form of purely ligamentous injuries or fracture-dislocations Hardcastle & Myerson classification For stable injuries treat non operatively with POP Operative management : closed reduction and percutaneous pinning or open reduction…
Lauge Hansen classified ankle fractures based on position of foot and direction of force into Supination adduction, pronation abduction, supination external rotation and pronation external rotation types Newer addition to this classification include vertical compression and unclassified types Indications for surgery include displaced fractures, unstable mortise with bi/tri malleolar fractures Outcomes associated with the use of a biodegradable plate and…
Stabilize the patient before you investigate Operative options include intramedullary nailing, ex-fix and plating Indications for retrograde nailing are: ipsilateral acetabular/neck fracture, floating knee, distal end fracture, morbid obesity etc Platting indications: deformed femur, neck fracture, pregnancy, narrow canal, impending FES Reaming not an issue in trauma patients without chest injuries who have been well resuscitated Benefits of reaming include…
Metatarsalgia (metatarsal pain) is a common complaint Weil osteotomy: Metatarsanl shortening osteotomies, 90% of patients reported good to excellent results Proximal Gastrocnemius Release: 69% patient satisfaction and increased ankle dorsiflexion after the surgery Repair of plantar plate and capsular insufficiency : Improvements in pain, deviation of the toe, MTP joint stability, muscle imbalance, joint congruence, and AOFAS scores
Compressive neuropathy of the interdigital nerve Most commonly involves the 2nd and 3rd interdigital nerve between the metatarsal heads Presents with pain worse with weight-bearing or wearing narrow toe box shoes Nonoperative treaments consists of shoe modification or orthotics, Soft metatarsal pad placed in the shoe etc No benefit to the steroid injections with regard to pain and function If symptoms persist after…