Cases reported "Hallux Valgus"

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11/27. Stress fracture of the first metatarsal after Keller bunionectomy.

    Complications following the Keller bunionectomy procedure are reviewed. The authors particularly reference metatarsal stress fractures. They describe a first metatarsal fracture sustained postoperatively in a 58-year-old diabetic patient.
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ranking = 1
keywords = operative
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12/27. Preoperative criteria for hallux valgus surgery and use of convergent angled base wedge osteotomy.

    A discussion is presented about objective correction criteria for hallux abducto valgus surgery. A historical review of commonly used procedures performed for correction at various levels of first ray deformity is related. Based on ideal criteria for base wedge osteotomies, a new template and procedure for base wedge osteotomies derived from computer-augmented graphics is described in detail. This procedure has been referred to as a convergent angled osteotomy (CAO) and effectively reduces the metatarsus primus adductus angle with minimal loss of length, cortex to cortex apposition in closure, relative lengthening with plantarflexion if desired, and a capacity for very stable rigid internal fixation that optimizes recovery from base wedge reduction. Case histories are also presented.
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ranking = 4
keywords = operative
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13/27. Opening base wedge osteotomy of the first metatarsal utilizing rigid external fixation.

    The authors describe their operative approach to metatarsus primus adductus deformity when present in conjunction with a congenitally short first metatarsal. Hallux abducto valgus correction in this clinical setting has traditionally advocated use of a crescentic or opening wedge osteotomy in order to prevent further shortening of the first metatarsal. Fixation of opening base wedge osteotomies has been fraught with problems in the past, with possibilities for displacement or eventual loss of initial correction. The authors have found the mini-Hoffmann external fixation device useful for this purpose.
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ranking = 1
keywords = operative
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14/27. The use of C-arm fluoroscopy and its application to podiatric surgery.

    C-arm fluoroscopy is a valuable diagnostic adjunct in podiatric surgery. It decreases operative time by allowing immediate visualization of the operative site without compromising operating room sterility.
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ranking = 2
keywords = operative
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15/27. The Wilson bunion procedure modified for improved clinical results.

    The Wilson procedure for correction of hallux abducto valgus is modified for use in three specific clinical conditions. The modifications are outlined and demonstrated in the preoperative conditions of 1) juvenile hallux abducto valgus, 2) functional hallux limitus, and 3) postoperative metatarsus primus elevatus. The rationale and biomechanical considerations for the modified Wilson bunion procedure are discussed.
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ranking = 2
keywords = operative
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16/27. Chronic osteomyelitis associated with monofilament wire fixation.

    Infections following osteotomy and internal fixation must be treated aggressively. The plan of treatment should include the following: 1) continued immobilization of the part during healing, 2) removal of any internal fixation device after the osteotomy site is stable, 3) debridement of necrotic debris, and 4) use of an appropriate antibiotic over a sufficient time period (including a few weeks after removal of an internal fixation device). A report was made of a case of chronic osteomyelitis that may have resulted from undertreatment of a postoperative infection.
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ranking = 1
keywords = operative
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17/27. Nosocomial postoperative tetanus infection.

    In light of the fact that tetanus spores are present throughout the environment, this article presents a case of nosocomial postoperative tetanus. A review of the immunization schedule is included to familiarize the surgeon with the active and passive methods of immunization. The authors recognize that tetanus infections are uncommon in our society, but all doctors should become aware of the appropriate treatment program as presented in this article.
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ranking = 5
keywords = operative
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18/27. Percutaneous osteoclasp fixation of akin osteotomy: an alternative fixation technique.

    An alternative method of fixating the Akin osteotomy which accomplishes compression osteosynthesis, maintenance of alignment, early ambulation in a rigid sole postoperative shoe, and the added advantage of early, complete removal of the fixation device without anesthesia is presented.
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ranking = 1
keywords = operative
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19/27. Sequential metatarsal stress fractures after Keller arthroplasty with implant.

    The occurrence of single stress fractures after Keller arthroplasties has been documented. This paper presents a case of sequential stress fractures of metatarsals two and three after Keller arthroplasty with hemi-phalangeal implant. It is the author's view that failure to recognize and properly treat the fracture of the second metatarsal led to the additional fracture of the third metatarsal. Furthermore, the use of a nonrigid orthotic with metatarsal padding is recommended postoperatively to decrease the probability of this complication.
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ranking = 1
keywords = operative
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20/27. Anatomic variations in the first ray: Part I. Anatomic aspects related to bunion surgery.

    dissection and roentgenographic findings in 35 nonoperative cadaveric and freshly amputated feet were correlated with disorders of the first day--specifically the sesamoids. There are four noteworthy factors associated with first ray pathology. The most significant are axial rotation of the first metatarsal bone and degenerative changes at the first metatarsophalangeal joint. Significant anatomic variations can be correlated with failed bunion surgery.
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ranking = 1
keywords = operative
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