This study evaluates the mid-term results of first metatarsophalangeal joint replacement (MTPJR) for hallux rigidus using the Toefit-Plus™ prosthesis. We prospectively studied the outcomes of 86 MTPJR in 73 patients using the AOFAS-HMI score and radiological follow up over a period from 2006 to 2013, with surgeries performed by a single surgeon at two centres. Patients were reviewed, scored and radiographs obtained pre-operatively and then at intervals of 6 weeks, 6 months, 12 months and then yearly. The mean follow up was 33 months (2–72).Introduction:
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This study presents a series of 64 patients undergoing tibio-talo-calcaneal (TTC) fusions with a hindfoot nail to compare the times to union and complications comparing use of allograft with no allograft. We conducted a retrospective review of patients undergoing a TTC fusion with a hindfoot nail from a period from 2010 to 2013. A total of 64 patients were collated which were performed by 3 surgeons across two centres. We reviewed the medical notes to determine the complications associated with the procedures and the radiographs to assess the time to clinical/radiological union. A comparison between the patients who had undergone a TTC fusion with allograft versus patients who had not received any allograft was made.Introduction:
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We report the outcomes of salvage procedures in total ankle replacement (TAR) in a single surgeon series. This study was a retrospective review of patients who had undergone salvage procedures with tibio-talo-calcaneal (TTC) fusion for failed TAR over a period from 1999–2013 in a single centre. In this period, 317 TAR were performed of which 11 have failed necessitating conversion to TTC fusion. Clinical documentation and radiographs were reviewed for cause of failure, type of graft for fusion, time to radiological/clinical union and complications including further surgeries.Introduction:
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This study was designed to assess the utility of the scarf osteotomy in the management of symptomatic adolescent This is a consecutive case series of 30 patients (40 feet) with a mean follow up of 38.2 months (range 6–60 months). The mean age at the time of surgery was 14.2 years (range 10–17 years). American Orthopaedic Foot and Ankle Society scores (AOFAS) were collected at final follow up, along with a rating of the overall satisfaction. Any complications were recorded. Pre and postsurgical radiographic angles were measured (HVA, IMA and DMAA) and analysed using the students ‘t’ test. A second surgeon additionally recorded the angles to measure the inter-rater reliability using the Pearson product moment correlation. The mean AOFAS score at final follow up was 91.2 (range 54–100). 87% of patients were either satisfied or very satisfied with their final outcome. 1 patient has been listed for revision surgery after symptomatic recurrence at 3 years follow up. Pre-op HVA, IMA and DMAA were 35.1, 16.1 and 16.3 respectively. Post-op values were 16.3, 8.8 and 9.0 (p < 0.001 for each). Pearson's r coefficient values demonstrated good inter-rater reliability of measurement.Methods
Results
Comminuted mid-foot fractures are uncommon. Maintenance of the length and alignment of the medial column, with restoration of articular surface congruity, is associated with improved outcomes. Conventional surgery has utilised open or closed reduction with K-wire fixation, percutaneous techniques, ORIF, external fixation or a combination of these methods. In 2003 temporary bridge plating of the medial column was described to reconstruct and stabilise the medial column. The added advantage of locking plates is the use of angle-stable fixation. We present our experience with temporary locking plates in complex mid-foot fractures. Prospective audit database of 12 patients over a 6 year period (2003-2009). 5 males 7 females mean age 41.9. Mechanism of injury: 11 high-energy injuries (6 falls from height, 5 RTCs), 1 low energy injury. Fracture type: All involved the medial column - 12 fracture dislocations of the medial column. 4 concomitant injuries to the lateral column. All underwent ORIF, realignment, and stabilisation with locking plates across the mid-foot.Introduction
Materials and methods
