Ankle & Foot – Page 2 – MBJ Clinic – Bone & Joint : Orthopedic Clinic

Hindfoot Arthritis

Nonsurgical management of hindfoot arthritis includes oral anti-inflammatories, steroid injections, and bracing Progressive condition, hindfoot arthritis typically requires arthrodesis Patient with prior calcaneum fracture need special attention while doing subtalar arthrodesis Maintain height subtalar joint area with graft Isolated talonavicular arthritis typically occurs in the setting of rheumatoid arthritis or Mueller-Weiss disease Subtalar and talonavicular arthrodeses typically done for adult-acquired…

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Midfoot Arthritis

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Causes : Ligamentous insufficiency, Trauma, Neuropathic arthropathy Treat non operatively with full leg rigid inserts for patients without deformity Midtarsal Arthrodesis: Reliable stable construct to achieve and maintain correction of the deformity External fixation was 8 times more likely to develop radiographic nonunion Results of surgery are good in non neuropathic High complications in neuropathic conditions

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Talus Fracture

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Talar neck fractures most common Mechanism of injury : forced dorsiflexion with axial load Investigations : x-ray and CT scan if needed Non operative management for un-displaced (<2mm) fractures Hawkins classification is used for talar neck fractures Displaced talar neck and/or body fractures should be treated with open reduction and internal fixation Common complications include osteonecrosis, ankle stiffness, arthritis

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Tarsal Coalition

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Genetically determined failures of bony segmentation Autosomal dominant inheritance pattern Symptoms first appear during adolescence Standing anteroposterior and lateral radiographs, 45° oblique films and Harris heel views Conservative management is first line of management Coalition resection is offered as next line of management and arthrodesis if subtalar arthritis has set in.

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