Download Atlas Foot and Ankle Surgery, Second Edition by Nikolaus Wülker, Michael Stephens, Andrea C. Cracchiolo PDF

By Nikolaus Wülker, Michael Stephens, Andrea C. Cracchiolo

The second one variation of An Atlas of Foot and Ankle surgical procedure builds at the luck of the 1st, with a global collection of professional individuals to symbolize the present perform of foot and ankle surgical procedure through the global. the cloth during this atlas is gifted in keeping with how foot and ankle pathology is encountered by way of so much orthopaedic surgeons of their perform. a few chapters take care of person universal methods, comparable to the gentle tissue technique for hallux valgus: in those, technical information and adaptations of procedure are offered. different chapters take care of diagnoses, comparable to metatarsalgia or cavus foot, and a few varied surgery techniques are defined. The scope of every bankruptcy exceeds surgical directions by myself: the respective pathology is targeted, as are diagnostic suggestions and substitute tools of remedy. The Atlas of Foot and Ankle surgical procedure can be of curiosity not just to green professional surgeons, but in addition to the final orthopaedists and healthcare professional in education with an curiosity in problems of the foot and ankle

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If the deformity is fairly flexible, however, then an arthrodesis may not be necessary if the deformity can be passively straightened to approximately 25°. If the range of motion of the first metatarsophalangeal joint is reduced to less than 40–50% of that of the opposite side, then rather than attempting a soft-tissue reconstruction of the hallux varus deformity an arthrodesis of the metatarsophalangeal joint would be preferable. When checking range of motion, it is important to establish whether or not it is painful; pain may indicate the presence of arthrosis, which also precludes a soft tissue reconstruction.

The longitudinal or horizontal cut is then followed by two transverse cuts. An osteotomy guide may be used to facilitate the bone cuts (Figure 4). 1-mm K-wire is inserted 3–4 mm below the dorsal medial surface of the metatarsal head and directed at a lateral and plantar declination of about 25–30° (aiming just plantar to the fifth metatarsal head). The proper direction of this guide pin is essential, since it will formulate the displacement of the metatarsal head-shaft. If the pin is directed lateral and plantar, the metatarsal head will be displaced laterally and plantarward; if directed slightly proximal, it will cause a small shortening of the metatarsal as well.

At the distal metaphyseal level, it divides into a branch for the sesamoids and metaphyseal capital branches. The lateral plantar artery divides into a lateral sesamoid artery and capital branches to the metaphysis, where an anastamosis occurs forming an important vascular arch under the metatarsal neck. qxd 5/12/2005 11:52 AM Page 31 Hallux valgus: scarf bunionectomy The scarf cut does not jeopardize this blood supply. Special care is taken during the lateral release, whether it is performed from the lateral incision, intermetatarsal approach or through the intraarticular approach.

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