Cuboid-Navicular Arthrodesis of the Foot After Arthroscopic Resection of Cuboid-Navicular Synchondrosis.
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ABSTRACT:
SUBMITTER: Padiolleau G
PROVIDER: S-EPMC9244640 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The accessory navicular bone is one of the most common accessory ossicles of the foot. Fewer than 1% of accessory navicular bones are symptomatic, and most of these are type II accessory navicular bones. A separation of the synchondrosis is considered one of the main causes of pain. After an injury to the synchondrosis has resulted in a chondro-osseous disruption, the combined forces of tension and shear from the posterior tibial tendon and the foot aggravate the injury and prevent it from healing. Fusion of the synchondrosis is a logical surgical treatment option if the pain is recalcitrant to conservative measures. The purpose of this technical note is to report an endoscopic approach to achieve fusion. It has the advantages of better cosmesis, less scar pain, less risk of nonunion, and potential to examine the tibialis posterior tendon and the talonavicular joint.
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Project description:This case report demonstrates a unique variant of a Chopart dislocation resulting in a plantar cuboid and navicular dislocation without concomitant fracture in a 48-year-old man. The mechanism of injury involved a low-energy plantarflexion moment from stepping off a small embankment. This report reviews the pertinent midfoot anatomy, discusses the proposed mechanism of injury, and demonstrates an effective method of treating these complex injuries with open reduction and internal fixation. Final results with 20 months of follow-up were excellent. This unusual midfoot dislocation is a complex injury that required open treatment for anatomic restoration. In complex Chopart dislocations, early open reduction should be strongly considered as the initial treatment to properly restore anatomy and function. Level of Evidence: Level V, expert opinion.
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Project description:Accessory navicular bone is a common accessory ossicle of the foot and is present in 10% to 14% of normal feet. Less than 1% of the accessory navicular bones are symptomatic. Degenerative or traumatic disruption of the accessory navicular synchondrosis is one of the main causes of symptomatic accessory navicular. The disrupted synchondrosis may or may not be associated with diastasis of the synchondrosis. Fusion of the synchondrosis is indicated if the pain fails to respond to conservative measures. The purpose of this Technical Note is to describe a minimally invasive approach for fusion of the synchondrosis that has no diastasis.
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Project description:Ankle arthrodesis is still considered the gold standard in the treatment of advanced painful ankle osteoarthritis. More than 3 decades ago, it was performed under arthroscopy; thereafter, many authors have reported excellent results and a low complication rate. Despite the significant improvements in surgical techniques, nonunion remains a problematic and relatively frequent event. This is one of the reasons the research is constantly active in this field. Ten years ago, a fibular resection during ankle arthrodesis was, for the first time, described in the literature as a means to correct malalignment in varus cases. Nowadays, we perform a similar technique during all arthroscopic ankle arthrodeses, regardless of the kind of preoperative deformity (varus, valgus, or normal alignment). In this article, we describe the arthroscopic technique to perform a fibular intra-articular resection during arthroscopic ankle arthrodesis, joining the benefits of arthroscopic minimal invasiveness to the full joint contact gained after such a fibular osteotomy. In our opinion, this would be the only way through which full contact between the talar and tibial surfaces may be achieved.
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Project description:BackgroundParalytic foot-drop is a disabling deformity that results from nerve or direct muscle injuries. Palliative surgeries such as tendon transfer and ankle arthrodesis are reserved for permanent deformity, with the arthroscopic technique had not been widely studied before. This study aims to evaluate the clinical outcome and quality of life after arthroscopic ankle fusion of paralytic foot-drop deformity.Materials and methodsThe patients who were retrospectively enrolled in this study underwent arthroscopic ankle fusion for paralytic foot-drop deformity between March 2017 and December 2021. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Cumberland Ankle Instability Tool (CAIT) were the measures used for clinical assessment. To judge the union, serial plain radiographs of the ankle were obtained. The preoperative and postoperative means were analyzed utilizing a two-tailed paired t-test, with a p value of less than 0.05 indicating statistical significance.ResultsThis study included 21 consecutive patients with a mean follow-up of 35.09 ± 4.5 months and a mean age of 41.5 ± 6.1 years. Highly significant improvements were observed between the preoperative and final follow-up means of the AOFAS score (from 57.6 ± 4.6 to 88.3 ± 2.7) and CAIT (from 12.1 ± 2.2 to 28.9 ± 1.01; p ˂ 0.00001 for both). All patients attained radiographic union and resumed their previous occupations without reporting serious adverse effects.ConclusionsArthroscopic ankle fusion is an effective, minimally invasive palliative surgery for patients suffering from permanent paralytic foot-drop deformity. This technique was shown to provide good functional and radiologic outcomes without significant complications.Level of evidenceRetrospective cohort; level of evidence (IV).
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Project description:Hypermobility of the first tarsometatarsal joint can associate with different clinical problems, e.g., hallux valgus, hallux elevatus, hallux rigidus, and transverse metatarsalgia or arthritis of the second metarsocuneiform joint. The first tarsometatarsal joint may also contribute to other foot deformities involving the medial foot column. Osteoarthritis of this joint is one of the causes of medial foot pain. Arthrodesis of the first tarsometatarsal joint (modified Lapidus procedure) is indicated for these conditions, which are resistant to conservative treatment. Lapidus arthrodesis has several potential complications, including first metatarsal shortening, metatarsal elevates, and nonunion. Arthroscopic Lapdius arthrodesis has been reported to reduce these complications. In this Technical Note, the technical details of arthroscopic Lapidus arthrodesis is described.
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Project description:Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores.
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Project description:Arthrodesis of the interphalangeal joint of the thumb is an effective treatment for pain, deformity, or instability at the joint. Arthroscopic interphalangeal arthrodesis of the thumb is a minimally invasive surgery and has better cosmetic results and less surgical trauma as compared with the open approaches. The purpose of this technical note is to report the details of the arthroscopic interphalangeal arthrodesis with oblique placement of the headless screw. No traction device is used for this technique. It is indicated in recalcitrant painful arthritis of the interphalangeal joint of the thumb. It is contraindicated in case of significant deformity of the joint as a result of subchondral bone collapse. It is also contraindicated if there is impinging volar osteophyte, local infection, or lack of expertise.
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Project description:Glenohumeral arthrodesis is an end-stage salvage operation that has traditionally been performed in an open fashion. In recent years an arthroscopic approach has been described. The purpose of this report was to present an arthroscopic glenohumeral arthrodesis technique with the assistance of O-arm-based navigation. An illustrative case example is presented. This technique allows not only a minimally invasive glenohumeral arthrodesis but also precise screw fixation by navigation, which may be particularly useful in cases of limited bone stock and/or bony deformity.
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