Index

Page numbers followed by f indicate figures; those followed by t indicate tables.

A Boyd, 480 posterior facet, 99 Chopart, 479-480, 480f relationships in, 119 Abductor digiti minimi muscle, 24 in diabetic patients, 519 and selection chart for surgical meth- vascular and nerve supply to, 21t guidelines in, 471-472 ods, 565f Abductor hallucis muscle, 24, 42, 43f of hallux, 474-475 talar declination, 98, 99f relocation of, 530, 532, 532f shoe and orthotic devices after, 475f talocalcaneal, 96-97 in tarsal tunnel syndrome, 406 lesser , 473f, 473-474 lateral, 98-99, 99f vascular and nerve supply to, 21t two or more in, 474, 474f talocuboid, 96, 97 Abductor ossis metatarsi quinti muscle, 24 Lisfranc, 479, 479f talometatarsal, lateral, 99 Accessory abductor muscle, 24 metatarsal ray resection, 476f, 476-477 talonavicular, 96f, 97 Accessory bones of foot, 14 Pirogoff, 480 Antibiotics in implant arthroplasty, 340, Acrolysis, radiographic features of, 75f, 84 Syme, 480 343-344 Acropachy, radiographic features of, 83 terminal, 472, 472f, 492-493 Aponeurosis, plantar, 19 Adductor hallucis muscle, 25, 42, 43f transmetatarsal, 477-478, 477f-478f Arcuate artery, 30f, 31-32 release in cerclage procedure, 547, 548f Anatomy, 7-36, 42-49 Arcuate base osteotomy, 247-249 vascular and nerve supply to, 21t bones, 9f, 9-14 Arteries of foot, 30f, 30-36 Adductor hallucis tendon transfer, 130- sesamoid, 154, 155f in bones, 34-35, 35f 131, 133 compartments in, 19, 19f in digits, 34 in cuneiform osteotomy, 288, 288f, 290 and embryonic development, 7-9 dorsal, 30f, 30-32 in hallux varus, 311 fascia, 18-20 plantar, 31f, 32-34 tibial sesamoid subluxation after, joints and ligaments, 14-18 plantar arch, 34-35 309-310, 310f in Morton's neuroma, 412, 4l2f, 4l3f Arthritis Adductovarus deformity of fifth toe, muscles, 20-26 gouty, radiographic features of, 76-78, 371-374 extrinsic, 20-23 77f-78f arthroplasty with phalangeal head intrinsic, 23-26 osteoarthritis, 334f resection in, 372f, 372-383 nerve supply, 20-24, 27f, 402, 402t, arthrodesis of first metatarso- middle phalangectomy in, 373f, 403f-406f cuneiform joint in, 280, 280f 373-374 of peripheral nerves, 402-403, implant arthroplasty in, 333 Adductus angle, forefoot, 97f, 97-98 407f-408f radiographic features of, 75-76, 76 Adolescent hallux valgus. See Juvenile hal- in tarsal tunnel syndrome, 408f psoriatic, radiographic features of, lux valgus vascular supply, 30f, 30-36 73-74, 73f-75f Age Angle measurements rheumatoid. See Rheumatoid arthritis and Reverdin procedure outcome, 203 articular set septic, radiographic features of, 78-79 and timing of surgery in juvenile distal, 113, 114f spondyloarthropathies, radiographic patients, 121 proximal, 111-113, 112f features of, 72-75, 73f-75f Akin procedure, 137, 138f, 561 tangential, 113, 113f Arthrodesis in abnormal distal articular set angle, calcaneal inclination, 98, 99f distal, of first two metatarsal bones, 137, 138f cuboid abduction, 96f, 97 545, 547f applications of, 140f-143f between first and second metatarsal, of first metatarsocuneiform joint, Austin osteotomy with, 176 55 279-284 cylindrical, 145, 145f forefoot adductus, 97f, 97-98 biomechanical considerations in, 284 distal, 144f, 145 hallux abductus, 111, 111f bone graft in, 282 fixation in, 137, 139f interphalangeus, 114f, 114—115 complications of, 283-284, 283f-284f in hallux abductus interphalangeus, hallux valgus, 41-42, 42f indications for, 279 137, 138f intermetatarsal, 111, 111f. See also intermetatarsal angle in, 282 in hallux varus, 311 Intermetatarsal angle length of first metatarsal in, 282-283 proximal, 139, 144f, 144-145 lateral deviation, 461-462, 46lf nonunion of, 283, 283f selection chart for, 565f metatarsal declination, 99, 99f in osteoarthritis after Lisfranc injury, Amputation, 471-480 metatarsus adductus, 95-96, 96f, 280, 280f 115-117, 116f

569 570 INDEX

Arthrodesis (Continued) and phalangeal head resection sway, 382-383, 383f plate fixation of, 281, 281f, 282, 282f in adductovarus deformity of fifth Ball-and-socket osteotomies in China, postoperative care in, 284 toe, 372f, 372-373 542t, 543 preoperative criteria for, 279-281 with condylectomy in heloma molle, Balog soft-tissue procedure, 126t procedure in, 281-284 363, 364f Barouk spacer, 354-355, 354f in severe hallux valgus, 279, 280f in heloma durum, 361-362, 362f Base osteotomies. See Proximal of first metatarsophalangeal joint, in rigid , 365-366, 366f osteotomies 267-277 in rigid mallet toe, 367-368, 368f Bio Action implant, 356 complications of, 276f, 277 in rheumatoid arthritis, 504-508, Biomechanics, 39-61 contraindications to, 267, 268t 505f-507f diabetes affecting, 522-523 dorsiflexion angle in, 272-273, 273f in tailor's , 462, 463f evaluation of, 106 end-to-end fusion in, 275 Articular set angle functional anatomy in, 42-49 "fish-scale" technique in, 276 distal, 113, 114f in hallux limitus/rigidus, 314 fixation methods in, 275 abnormality correction with Akin in hallux valgus development, 49-54, frontal plane rotation in, 271, 272t procedure, 137, 138f 107-108 goniometry in, 273, 273f proximal, 111-113, 112f in childhood, 119 in hallux limitus/rigidus, 270f, 324, in Mitchell bunionectomy, 199, in implant arthroplasty, 327-328 334t 200-201 in Morton's neuroma, 413-414, 414f hallux varus from, 270, 271f preoperative determination of, 228, in motions of first metatarsophalangeal improper sagittal plane positioning 232, 232f joint, 44-49 in, 273-274, 274f realignment in cuneiform osteotomy, radiographic evaluation of, 95-99 indications for, 267t 285-286, 290, 290f in anteroposterior view, 95-98, intermetatarsal angle in, 268, 270, reduction with distal osteotomies, 96f-97f 167 271f in lateral view, 98-99, 98f-99f nonunion of, 276f, 277 in Reverdin procedure, 204 in rheumatoid arthritis, 499-500 tangential, 113, 113f peg-in-hole and conical fusions in, in stretching and contraction of struc- 275 Austin osteotomy, 164f, 166-167, 169-180, tures, 126, 127f 170f, 562, 564 position of fusion in, 271-275, 272t, Block balance testing, 383, 384f 272f-273f advantages of, 176 Akin procedure with, 176 Blood supply of foot. See Vasculature and preoperative with Bone graft patient wearing shoe, 272, 272f apex wire in, 173, 173f bicorrectional, 169, 170f in arthrodesis of first metatarso- Reese osteotomy guide in, 274-275 cuneiform joint, 282 and resection arthroplasty in rheuma- compared to other procedures, 178 complications of, 178t, 179f-180f, 180 in cuneiform osteotomy, 285, 290, 292 toid arthritis, 505, 506f osteocartilaginous, 552-560, 553f sagittal plane position in, 272t, contraindications for, 171t Bone scans in infections after implant 272f-273f, 272-274 fixation of, 174, 175f incorrect alignment in, 174, 178f arthroplasty, 343 in salvage of failed implant, 269f Bone stock quality in severe hallux valgus, 268f lateral dissection with, 176 postoperative care in, 174 for implant arthroplasty, 335, 336, 339 simple cartilage resection in, 276 potential three-dimensional effects of, for proximal osteotomies, 232, 234f surgical procedure in, 275-277 169, 171f-172f, 174 "Bone within a bone" appearance, disor- transverse plane position in, 271-272, preoperative and postoperative ders with, 84 272t radiographs in, 177f Bones of foot, 9f, 9-14 of interphalangeal joint, 147-151 range of motion after, 176f accessory ossicles, 14 choice of procedure in, 150 results of, 563 blood supply to, 34-35, 35f Dickson-Dively operation in, 147, reverse, in tailor's bunion, 464-466, 465f metatarsal, 10f, 10-13 148f selection of patients for, 169-171 os intermetatarseum, 14 Kirschner wire fixation in, 149 chart for, 565f phalanges, 13-14 review of literature in, 147-150 sesamoidectomy with, 176 sesamoid, 14, 42, 153-161 Synthes Cannulated Screw System in, soft-tissue procedures in, 172 Bonney-Kessel procedure in hallux limi- 150-151, 150f transposition of capital fragment in, of interphalangeal joints, 145-146 tus/rigidus, 322-323, 323f 173, 174f, 176 Bowstringing of tendons, 20, 53 phalangeal, in dynamic hammer toes or Avascular necrosis of metatarsal head. See claw toes, 369-370, 370f Boyd amputation, 480 Arthrometric examination in forefoot pain, Freiberg's disease Brachydactyly, radiographic features of, 84 Axial artery, embryonic development of, 514t Brachymetatarsia, 435, 437f 7-8 Arthroplasties, resection, 295-305, 296t Brandes arthroplasty, 295, 296t Axons, 402 in dynamic hammer toes or claw toes, Bunion dorsal, 313 368-369, 370f B in hallux limitus/rigidus, 324, 324f tailor's, 459-469 implants in. See Implant arthroplasty Balance testing Bunionette. See Tailor's bunion osteocartilaginous grafts in, 552-560 block, 383, 384f Bursitis, 103, 104f INDEX 571

C dynamic, arthroplasty/arthrodesis proce- in metatarsus primus adductus, 285, dures in, 368-370, 369f-371f 289, 289f Calcaneal nerve, inferior, entrapment of, postoperative care in, 291 407-409 rigid, 366f, 366-367 postoperative contour in, 290, 290f Calcaneocuboid angle, 96f, 97 arthroplasty and phalangeal head proximal articular set angle realign- Calcaneus, 9f resection in, 366-367, 367f ment in, 285-286, 290, 290f inclination angle, 98, 99f Clayton arthroplasty, 295, 296t surgical procedure in, 288-290, Calcifications, radiographic features of, in rheumatoid arthritis, 504 288f-290f 87-89, 89f Clinical evaluation, 101-106, 109-110 relation to first metatarsal, in metatarsus in vascular calcifications, 89 appearance of severe deformity in, primus varus, 108-109 Callus formation 228f Cutaneous nerves, 403f, 404f, 405f evaluation of, 110 in juvenile hallux valgus, 120-121 dorsal plantar, 430, 433 orthodigital procedures in, 379-385 intermediate, 27f, 28 weight-bearing loads affecting, 58, 59f patient history in, 101-102, 109 lateral, 27f, 28 Cannulated Screw System, 150-151 physical examination in, 102-106, medial, 27f, 28 Capillary plexus 110 Cyma line, lateral, 98, 98f periosteal, 34-35, 35f in tailor's bunion, 460 subcutaneous lymphatic, 36 Closing wedge osteotomy CAPP osteotomy, 165 cuboid, cuneiform osteotomy with, 291, D Capsulotomy, 127 291f closure of, 130 cuneiform, 285 Dactylitis, disorders with, 89-90 Carbon, pyrolytic, as implant material, proximal, 242, 242f-243f Degrees of deformity in hallux valgus, 355-356 Compartments of foot and leg, 19, 19f 552-553 Cavus forefoot, 436, 439f Computed tomography, 93-95 DePuy implant, 352-353, 352f Central ray insufficiency and overload syn- advantages of, 94 Dermatologic examination, 103 dromes, 429 Hounsfield units in, 94t Dermatome mapping of lumbar and sacral Cerclage procedures, 545-550 indications for, 95 nerve roots, 406f adductor hallucis release in, 547, 548f limitations of, 94-95 Derotational-type osteotomy of proximal complications of, 549 Condylectomy, plantar, 440-441, 442f phalanx, 145 criteria for, 545-546 Convex forefoot, 436, 439f Diabetes mellitus distal osteodesis of first two metatarsal triangular, 436 biomechanical alterations in, 522-523 bones in, 545, 547f Corns. See also Heloma durum; Heloma Charcot joint arthropathy in, 79f, 79-80 Goeball, 545, 546f molle neuropathies in, 521-522 Joplin, 545, 546f Lister's, 361, 36lf, 363 osteolysis of fifth toe in, 81f Lenggenhager, 545, 546f Cortical arteries of bone, 34 perioperative risks in, 522t Lexer, 545, 546f Crescentic or arcuate base osteotomy, prophylactic foot surgery in, 519-528 nylon sutures around bones in, 548, 548f 247-249 guidelines for diabetes control in, results of, 548-549, 549f-550f Cryptotic nails. See Onychocryptosis 521, 521t, 525-528 skin incision in, 547, 547f Cuboid bone, 9f symptoms of insensitive foot in, 522t technique in, 547 abduction angle, 96f, 97 ulcerations of foot in, 520-521 Cerebral palsy, juvenile hallux valgus in, closing wedge osteotomy, cuneiform with neuropathic edema, 522 119 osteotomy with, 291, 291f vascular pathology in, 522 Charcot joint arthropathy, radiographic Cuneiform bone, 9f Dickson-Dively operation, 147, 148f features of, 79-81, 79f-81f atavistic, 109, 285 Digital arteries, proper Cheilectomy in hallux limitus/rigidus, deformity in juvenile hallux valgus, 120 dorsal, 32 320-322, 321f-322f, 334t metatarsocuneiform joint, 118, 118f plantar, 34 Chevron osteotomy, 169 arthrodesis of, 279-284 Digital deformities, 359-376 in Japan, 534, 534f orientation affecting metatarsus classification of, 359, 360f, 360t Childhood, hallux valgus in. See Juvenile primus adductus development, 56, dynamic, 368-376 hallux valgus 56f from intrinsic muscle wasting, 371, China, hallux valgus in, 540-543 osteotomy of, 285-293 371f clinical data in, 540 adductor tendon transfer in, 288, orthodigital evaluation in, 379-385. See etiology and pathogenesis of, 540-541 288f, 290 also Orthodigital evaluation shoes affecting formation of, 541, 54lt ancillary surgical procedures in, 291, orthodigital therapy in, 385-399. See surgical procedures in, 541-543, 542t 291f also Orthodigital therapy Claw toe bone graft in, 285, 290, 292 osseous procedures in, 359, 361 correction of, 147-149, 148f-149f, complications of, 292 plantar lesions with, 433, 434f 366-370 effects of, 287f, 287-288 soft-tissue procedures in, 359 historical review of, 285-286 static, 360t, 361-368 Hohmann osteotomy with, 285-286 with contraction, 365-368 indications for, 286, 286f in medial column adductus, 289f, 289-290 572 INDEX

Digital deformities (Continued) Epiphysiodesis in juvenile hallux valgus, First intermetatarsal angle in hallux abduc- without contraction or rotation, 361-365 121 tus, 55, 56 tendon transfers in, 359 Etiology of hallux valgus, 1-2, 39-41, First metatarsal bone, 11-12, 12f Digital nerves, proper, 404f, 405f 107-109 adduction of dorsal, 27, 27f, 28, 29-30 biomechanics in, 107-108 atavistic, 120 plantar, 27f, 28, 29-30 in childhood, 119 and juvenile hallux valgus, 120 Dislocation of implants, management of, metatarsus primus varus in, 108-109 blood supply to, 35 341 Evaluation of patients. See Clinical evalua- length of Distal osteotomies, 163-167 tion in arthrodesis of first metatarso- Austin, 164f, 166-167, 169-180, 170f Exercises cuneiform joint, 282-283 CAPP, 165 for digital malpositions, 389, 392, 398f compared to second metatarsal. See DRATO, 164f, 165 postoperative, 134 Metatarsal protrusion, relative Hohmann, 164f, 165 Exostectomy increased in hallux valgus patients, in juvenile hallux valgus, 121 lateral, in tailor's bunion, 461, 462f 56, 57 L type, 163, 164f subungual, 494-495, 495f in Mitchell bunionectomy, 200 Lindgren and Turan, 164f, 166 Extensor digitorum brevis muscle, 22, osteotomy in China, 542t, 542-543 Miller, l64f, 165 23-24, 44 First metatarsophalangeal joint, l6f, 17 Mitchell, 164f, 165 vascular and nerve supply to, 21t anatomy and function of, 42-49 Mygind, 164f, 166 Extensor digitorum longus muscle, 44 normal anatomy in, 43f Peabody, 163, l64f vascular and nerve supply to, 21t entrapment neuropathies near, 410-411, peg-in-hole, l64f, 166 Extensor expansions, 20, 26, 26f 441f Reverdin, 163, l64f Extensor hallucis brevis tenotomy, 130 motions of, 44-49 Roux, 163, 164f Extensor hallucis capsularis, 22 axis of dorsiflexion-plantar flexion in, transverse, 164f, 166 Extensor hallucis longus muscle, 22, 44 45-46, 45f-46f Wilson, 164f, 165-166 in hallux valgus development, 53f, first-ray axis in, 47f, 47-48, 48f Dorsal bunion, 313 53-54 in frontal and sagittal planes, 47-48 Dorsalis pedis artery, 30f, 30-31 vascular and nerve supply to, 21t muscle activity in, 49 Down syndrome, juvenile hallux valgus Extensor hallucis longus tendon normal range of dorsiflexion in, 313 in, 119 lengthening of, 130 in primates, compared to humans, 47 Downey implant, 349, 349f transfers of, 147-150, 148f-l49f in propulsion, 46-47, 47f DRATO osteotomy, 164f, 165 in hallux varus, 311 rearfoot motions affecting, 48-49, DuVries soft-tissue procedure, 134 Extensor sling, 26, 26f 57f, 57-60 Dwyer procedure in rheumatoid arthritis, Extensor wing, 26, 26f in transverse plane, 44-45, 45f 504 vertical axis in, 44, 52f, 53 Dyskeratosis, palmar-plantar, 430, 432f F weight-bearing loads in, 56-58, 59f First ray Fascia of foot, 18-20 deformity in juvenile hallux valgus, E deep, 19-20 119-120 dorsal, 19 direction of triplane axis in, 108 Edema extensor expansions, 20, 26, 26f dorsiflexion of, 105, 105f after implant arthroplasty, 341 flexor sheaths, 20 hypermobility of, 107-108 neuropathic, in diabetes, 522 plantar, 19 sesamoids in, 156 Electromyograph activity of foot muscles, sagittal septa, 19 insufficiency syndrome, 429 50f superficial, 18-19 muscle instability of great toe in, in tarsal tunnel syndrome, 406 vertical fibers, 19 435-436, 438f Embryonic development Fascicles, peripheral nerve, 403 short great toe in, 435, 436f of first metatarsal, 120 Femoral artery, embryonic development long, 435, 437f of limbs, 7-9 of, 7 overload syndrome, 429 of sesamoids, 153-154 Fibroma, perineural, 401, 412 plantar flexion of, 105, 106f Enclavement, 442f Fibular sesamoid, 14 range of motion evaluation, 105, 110 in hallux limitus/rigidus, 334t release of, 129, 129f First-ray axis, 47f, 47-48, 48f Regnauld reenclavement procedure, removal of, 129, 133 Flail hallux, implant arthroplasty in, 334 567, 567f hallux varus from, 129, 134, 308, Flat triangular forefoot, 431f, 436, 439f Endler implant, 347 308f Flexor digiti minimi brevis muscle, 25 Endoneurium, 403 Entrapment Fifth metatarsal bone, 13 vascular and nerve supply to, 21t neuropathies, 401-425. See bunion of. See Tailor's bunion Flexor digitorum brevis muscle, 24 also Neuropathies Fifth toe vascular and nerve supply to, 21t Epineurium, 403 adductovarus deformity of, 371-374 Flexor digitorum longus muscle, 23 Epiphyseal arteries, 34, 35f congenital overlapping of, 374f, vascular and nerve supply to, 21t Epiphyseal plate, 9 374-375 Flexor hallucis brevis muscle, 25, 42, 43f relocation of digit in, 374f, 374-375 INDEX 573

vascular and nerve supply to, 21t H in transection of tendons, 309 Flexor hallucis longus muscle, 23, 43f, 44 soft-tissue procedures in, 310 in hallux valgus development, 52f, 53 Hallux abductus angle, 111, 111f static deformity in, 310 vascular and nerve supply to, 21t in Mitchell bunionectomy, 199 Hammer toe Flexor hallucis longus tendon and soft-tissue procedures, 132, 133f dynamic, arthroplasty/arthrodesis proce relation to sesamoids, 154, 155 Hallux abductus interphalangeus angle, dures in, 368-370, 369f-371f 114f, 114-115 transfers of, 147 rigid, 365-366 Force-sensing resistors, 513 abnormal, Akin procedure in, 137, 138f, arthroplasty and phalangeal head 140f-143f Forefoot adductus angle, 97f, 97-98 resection in, 365-366, 366f Hallux adductus, Austin osteotomy in, 178 Foreign body, subungual, 484, 484f Harris-Beath angle, 96, 96f Hallux amputation, 474-475 Harris-Beath radiologic view, 69, 70f Fourth metatarsal bone, 13 Hallux equinus, 313 Heel pad thickening, disorders with, 90 Fowler procedure, 126t Hallux limitus/rigidus, 313-325, 328, 329f Helal oblique osteotomy, 442f, 443, in onychocryptosis, 491, 491f Bonney-Kessel procedure in, 322-323, 565-567, 566f in rheumatoid arthritis, 504 323f reverse, 567, 567f Fractures causes of, 333, 333t Helal spacer, 352, 352f of implants, 342 cheilectomy in, 320-322, 321f-322f Heloma durum, 361 of sesamoids, 159, 160f, l6lf conservative treatment of, 320 arthroplasty and head resection in, Freiberg's disease, 435f, 453-457 etiology of, 313-314, 3l4f, 315f, 3l6f 361-362, 362f conservative therapy in, 455 hypermobility in, 314, 315f debridement of hyperkeratotic tissue in, etiology of, 453-455 new bone formation in, 314, 3l6f 372, 372f metatarsal length and mobility in, osteochondral bone island in, 314, distal, 361, 36lf 454 317f of lateral nail groove, phenol and alcohol plantar pressure in, 454-455 implant arthroplasty in, 324-325, 333 matrixectomy in, 488, 489f trauma in, 453-454 alternatives to, 333, 334t proximal, 361, 36lf loose bodies in, 455 joint-destructive procedures in, 323-324, Heloma molle metatarsal shortening osteotomy in, 324f mild to moderate, 363, 363f 455f-456f, 456 Keller procedure in, 324, 324f operative technique in, 363, 364f metatarsalgia in, 434 Lapidus procedure in, 323, 323f severe recurring, 363-365 prognosis of, 456-457, 457t metatarsophalangeal joint fusion in, syndactylization of fourth and fifth radiographic appearance of, 453, 454f 270f toes in, 363-365, 365f treatment of, 455t, 455-456 radiography in, 318f, 318-319 Hematoma long-term results of, 457t staging of, 319, 319t after implant arthroplasty, 341, 34lt Fricke arthroplasty, 295, 296t surgery in, 320t, 320-323 after surgery in Morton's neuroma, 423 Frost procedure in onychocryptosis, 485, symptoms of, 315, 317f subungual, 481 486f Watermann procedure in, 323, 323f Hemi-implants, 330-331, 331t Fungus infections, and total nail avulsion Hallux valgus, definition of, 529 indications for, 335 in onychomycosis, 493-494 Hallux varus, 307-311, 308f problems with, 342 Fusion procedures. See Arthrodesis acquired, 285 Swanson, 330, 331t, 345, 347, 349, 349f congenital, 307 titanium, 345, 354, 354f correction of, 310-311 Hereditary factors in hallux valgus, 41 Heubach arthroplasty, 295, 296t G dynamic deformity in, 310 implant arthroplasty in, 333-334, 334 Hilton arthroplasty, 295, 296t

postoperative, 285-288 Hiss bunionectomy, 125 GAIT implant, 356f, 357 in adductor hallucis tendon transfer, Historical aspects of hallux valgus surgery, Giannina and Moroni implant, 357 Gibson 309-310, 310f 2-4 oblique osteotomy, 533f, 533-534 in aggressive postoperative bandag- implant arthroplasty in, 328-330 Girdlestone-Taylor tendon transfer for ing, 309 History of patient, 101-102, 109, 379-380 claw toe correction, 148, 148f in excessive medial eminence resec- Hoder-Dobbs procedure in rheumatoid Goeball procedure, 545, 546f tion, 308, 309f in fibular arthritis, 504 Golden osteotomy with distal soft-tissue sesamoidectomy, 129, 134, Hoffman procedure in rheumatoid arthritis, release, 227, 254-255, 255f, 266 308, 308f 504 Gonococcal arthritis, radiographic features in improper correction of osseous Hohmann osteotomy, l64f, 165, 183-195, of, 79 deformities, 308-309 184f Gore procedure, 563 in metatarsocuneiform joint fusion, axis of, 183-184, 184f results of, 563-564 283, 284f capital fragment transposition in, selection chart for, 565f in metatarsophalangeal joint fusion, 184-185, 185f Gouty arthritis, radiographic features of, 270, 271f cuneiform osteotomy with, 285-286 76-78, 77f-78f in overaggressive medial capsulorrha- fixation in, 187, 187t, 188f, 189f, 192- Gripping response of digits, 382, 382f phy, 309 194, 194f Growth plate, 9 574 INDEX

Hohmann osteotomy (Continued) Giannina and Moroni, 357 Intermetatarsal ligaments, 15 in , 192, 192f-193f Helal spacer, 352, 352f deep transverse, 17-18 in Japan, 532-533, 533f Joplin, 349 in surgery of Morton's neuroma, objectives of, 185-186 Kampner, 350, 350f 419, 421 postoperative bracing in, 187-188 Koenig, 354-355, 355f International perspectives results of, 188-195 LaPorta, 331t, 331-332, 332f, 353f, cerclage procedures, 545-550 in severe deformity, 190f-191f, 190- 353-354 Austria, 561-568 192 Lawrence, 331t, 332, 332f, 353, China, 540-543 surgical technique in, 186-187 353f Japan, 529-539 in tailor's bunion, 463, 464f Lu, 355-356, 356f osteocartilaginous graft procedure, variations in, 189 Lubinus, 354 552-560 Hounsfield units, 94t Merkle, 355 Interosseous muscles Hueter arthroplasty, 295, 296t pyrolytic carbon, 355-356 dorsal, 25-26 Hyperkeratosis Regnauld, 351, 351f vascular and nerve supply to, 21t evaluation of, 103 Richards, 351, 351f plantar, 25 plantar, 430-433, 431f-432f Seeburger, 347-349, 348f vascular and nerve supply to, 21t Hypermobility, 107-108 Swanson. See Swanson Interphalangeal joints, 18 and hallux limitus/rigidus formation, implants arthrodesis of, 145-146 314, 315f Weil, 330, 331t, 352, 352f fibrous capsule of, 18 sesamoids in, 156 Wyss, 355 synovial cavities of, 18 Hyperostosis, diffuse idiopathic skeletal, ZMR toe, 354 Interphalangeal ligaments, 18 radiographic features of, 81-82, 82f indications for, 333t, 333-335 Intersesamoidal ligament, l6f, 17, 42 Hypervitaminosis A, radiographic infections after, 341, 342-343 Ischemia of toes after surgery in features of, 83 life span of implants in, 331, 335 materials used in, 330, 330t, 345 Morton's neuroma, 423 osteotomy orientation in, 336 Isherwood medial oblique view, 68, 69f I physical therapy after, 340-341 Ishizuka osteotomy, 534-536, 535f-536f placement of implants in, 336f-337f, Iliac lymph nodes, 36 338, 339f Implant arthroplasty, 327-345 postoperative care in, 340-341 J alignment problems in, 342 in edema, 341 biomechanical issues in, 327-328 in hematoma, 341 Japan, hallux valgus in, 529-539 bone problems after, 344, 344f in infection, 341 abductor hallucis relocation in, with bone stock quality in, 335, 336, 339 reactions to silicone in, 344 chiseling of first metatarsal classification of implants in, 347, 348t sizing of implants in, 338 head, 530, 532, 532f complications of stem holes in, 337f, 338, 340 bone procedures in, 530, 532-536 intraoperative, 339-340 surgical procedure in, 335-338, chevron osteotomy in, 534, 534f postoperative, 341-344, 344f 336f-337f, 339f, 340t Gibson oblique osteotomy in, 533f, criteria for use of, 335, 335t in tailor's bunion, 462 533-534 dislocation of implants in, 341 technical objectives of, 339t Hohmann osteotomy in, 532-533, dual-component implants in, 345 tissue problems in, 342-343 533f foreign body reactions in, 338 titanium in, 345 Keller procedure in, 532, 532f fracture of implants in, 342 Infection McBride procedure in, 530, 531f functional objectives of, 333-334, after implant arthroplasty, 341, 342- Mitchell osteotomy in, 534, 535f 335t 343 number of surgeries in, 529, 531t in hallux limitus/rigidus, 324-325 of sesamoids, 156, 157f and phalangeal valgus, 536-537, in hallux varus, 310 Ingrown nails, 482-493. See also 537f hemi-implants in, 330-331, 331t Onychocryptosis results of surgery in, 538t, 538 Inguinal lymph nodes, 36 indications for, 335 and severe deformity from Injection therapy in Morton's neuroma, problems with, 342 rheumatism, 537f, 537-538 titanium, 345, 354, 354f 417, 418f soft-tissue procedures in, 530-532 historical aspects of, 328-330 Intermetatarsal angle, 111, 111f in arthrodesis of first metatarso- Swanson artificial joint in, 536, 536f ideal patient in, 335, 335t Z-shaped (Ishizuka) osteotomy in, implant designs in, 330-332, 331t, cuneiform joint, 282 534-536, 535f-536f 347-357 first, in hallux abductus, 55, 56 Joint-destructive procedures, 295—305, Barouk spacer, 354, 354f fourth, in tailor's bunion, 460-461, 296t. See also Arthrodesis; Bioaction, 355 46lf Arthroplasties, resection DePuy, 352, 352f increase in hallux valgus, 552 in hallux limitus/rigidus, 323-324, 324f, Downey, 349, 349f in metatarsophalangeal joint fusion, 268, 270, 271f 334t Endler, 347 Joints of foot, 14-18 GAIT, 356, 356f in Mitchell bunionectomy, 199-200 preoperative determination of, 227- intermetatarsal,15 228, 229f-230f interphalangeal, 18 reduction with distal osteotomies, 167 and soft-tissue procedures, 132, 133f INDEX 575

metatarsophalangeal, 15-17 L tarsometatarsal, 14-15 tarsometatarsal, 14-15 transverse metatarsal deep, Jones operation for claw toe, 148-149, L-type osteotomy, distal, 163, l64f 17-18, 18f, 20f 149f Laciniate ligament in tarsal tunnel syndrome, superficial, 19 Joplin cerclage procedure, 542t, 543, 545, 406, 408f Lindgren and Turan osteotomy, 164f, 166 546f Lapidus fusion procedure, 228, 231f, 265, Lisfranc amputation, 479, 479f Joplin implant, 349 279 Lisfranc joint Joplin neuroma, 411, 411f in China, 542t, 543 frontal convexity affecting metatarsal Juvara osteotomy, 243-247, 244f-247f Lapidus nail excision in onychocryptosis, positions, 436, 439f fixation of, 247, 247f 492, 494f hypertrophic Charcot deformity of, 80f procedure in, 243-246, 244f-246f Lapidus osteotomy in hallux Lisfranc ligament, 15 Juvenile hallux valgus, 119-122, 121f limitus/rigidus, 323, 323f Lister's corn, 361, 36lf, 363 Austin osteotomy in, 178 LaPorta implant, 331t, 331-332, 332f, 353f, Logroscino osteotomy, 227, 251-254 clinical evaluation in, 120-121 353-354 procedure in, 252f-254f, 253 complications of surgery in, 121-122 placement of, 336f-337f Loose bodies, intra-articular dynamic, 119-120 Larmon procedure in rheumatoid arthritis, disorders with, 89 recurrence after soft-tissue procedures, 134 504 in Freiberg's disease, 455 static, 120 Laser treatment for ingrown nails, 489 Lothrop soft-tissue procedure, 126t Lu implant, 355, 356f surgical procedures in, 121 Lawrence implant, 331t, 332, 332f, 353, Lubinus implant, 354 timing of, 121 353f placement of, 336 Ludloff osteotomy, 215-217, 2l6f, 219f Lenggenhager procedure, 545, 546f advantages and disadvantages of, Length of metatarsal bones. See Metatarsal 216-217 K bones, length of indications for, 215 Lenox-Baker osteotomy, 256, 258f Mau modification of, 217-221, 218f, 219f, Kampner implant, 350, 350f Lesser metatarsal surgery, 440-449, 442f 255-256, 256f Kaplan procedure in onychocryptosis, 491 collectomy in, 442f, 445 operative technique in, 216, 217f Kates procedure in rheumatoid arthritis, comparison of procedures in, 445 plane of motion for, 217, 218f 504 condylectomy in, 440-441, 442f postoperative care in, 216 Kelikian push-up test, 370 distal metaphyseal osteotomies in, 442f, preoperative radiographs in, 215 Keller arthroplasty, 4, 295-305, 328, 561, 563, 443 Lumbrical muscles, 24-25 564 distal V osteotomy in, 442f, 444, 445, vascular and nerve supply to, 21t adaptation in tailor's bunion, 462, 463f 446f Lupus erythematosus, radiographic features in China, 542, 542t Helal osteotomy in, 442f, 443 of, 78 complications of, 302-303, 302f-305f metatarsal head recession in, 442f Lymph nodes, 36 criteria for acceptable results in, 301- metatarsal head resection in, 440, 442f Lymphatic vessels, 36 302 metatarsal shortening after, 448 in hallux limitus/rigidus, 324, 324f, 334t multiple osteotomies in, 445 indications for, 299 osteoclasis in, 441, 442f M intraoperative difficulties in, 301 proximal dorsiflexory wedge osteotomy in Japan, 532, 532f in, 442f, 444 Magnetic resonance imaging, 91-93 objective of, 299 proximal V osteotomy in, 442f, 444-445 advantages of, 93 operative procedure in, 299-301, 300f simultaneous adjacent osteotomies in, common overlap pathologies in, 93 key points of, 301 446, 448 indications for, 93 recommended variations in, 296-299 success rate in, 445-446 limitations of, 93 postoperative care in, 303-305 tilt-up osteotomy in, 442f, 443-444, 445 normal signal intensities in, 92-93 preoperative measures in, 299 Lexer procedure, 545, 546f Magneto resistor sensors, 513 push-up test after, 301, 301f Ligaments of foot, 14-18 Mallet toe, rigid, 367-368 results of, 563 annular, 20 arthroplasty and phalangeal head resection selection chart for, 565f cruciate, 20 in, 367-368, 368f tenopexy in, 297-298, 298f Keratotic at first metatarsophalangeal joint, 42 Marginal artery, medial plantar, 33 lesions, plantar, 430-433, intermetatarsal, 15 Marginal veins of foot, 36 431f-432f deep transverse, 17-18 Mau osteotomy, 217-221, 218f, 219f, 255- Kite angle, 96, 96f interphalangeal, 18 256, 256f Knot of Henry, 23 intersesamoidal, 16f, 17, 42 advantages and disadvantages of, 220- Koenig implant, 355, 355f metatarsophalangeal, 10, 15-17 221 Kotzenberg procedure, 256, 257f metatarsosesamoideal, medial and lateral, indications for, 218 selection chart for, 565f 16f, 17 modifications of, 219-220, 221f Kramer arthroplasty, 295, 296t sesamoideophalangeal, l6f, 17 operative procedure in, 219, 220f biomechanical alterations in, 108 outcome of, 222f 576 INDEX

Mau osteotomy (Continued) plantar condyles of, 10f, 11 Mitchell bunionectomy in, 200 plane of motion for, 218f second, 12 Youngswick osteotomy in, 169, 170f postoperative care in, 220 shaft of, 11 Metatarsus primus varus, 108-109 preoperative radiographs in, 218-219 surgical neck of, 10f, 11 congenital, 120 Mauclaire soft-tissue procedure, 126t third, 13 Miller osteotomy, 164f, 165 Mayo arthroplasty, 4, 295, 296t transverse and oblique axes of, 438, 440f Minimal incision surgery Akin procedure in, 137, 138f McBride procedure, 125-126, 131, 133 tubercles of, 10f, 11 Metatarsal ligament in China, 542t, 543 in China, 542, 542t, 543 deep transverse, 17-18, 18f, 20f New's procedure in, 561-562 in Japan, 530, 531f superficial transverse, 19 Mitchell procedure, l64f, 165, 183, McGarvey-Johnson procedure in rheuma Metatarsal protrusion, relative, 1011, 115, 197-202 toid arthritis, 504 1l6f in China, 542t, 543 Meary's angle, 99 in juvenile hallux valgus, 120 compared to Austin procedure, 178 Medial eminence resection, 127, 128f preoperative determination of, 232, 234f contraindications for, 200 excessive, hallux varus from, 308, 309f and soft-tissue procedures, 132 fail-safe holes in, 198, 198f tibial sesamoid peaking after, 129, 130f, Metatarsal ray resection, 476f, 476-477 fixation in, 199 134 Metatarsalgia, 57, 429-449, 564-568 hallux abductus angle in, 199 prevention of, 127, 129f classification of, 429-430 indications for, 199-200 Medical history of patient, 101-102 distal shortening osteotomy in, 567, 567f intermetatarsal angle in, 199-200 Medullary arteries of bone, 34 etiology of, 430-440 in Japan, 534, 535f Merkle implant, 355 forefoot correction in, 567-568 length of first metatarsal in, 200 Metaphyseal arteries, 34, 35f Helal telescoping osteotomy in, metatarsus primus elevatus in, 200 Metaphyseal osteotomies, distal, in plantar 565-567, 566f modifications of, 200-201 lesions, 442f, 443 management of, 440-449. See also operative technique in, 197-198, 198f Metatarsal arteries, 33f Lesser metatarsal surgery outcome of, 201f, 201-202 dorsal, 30f, 31, 32 osseous problems in, 434-435 proximal articular set angle in, 199, principle sources of, 32t plantar lesions in. See Plantar lesions 200-201 plantar, 33f, 34 Regnauld reenclavement procedure in, in tailor's bunion, 464, 465f Metatarsal bones, 10f, 10-13 567, 567f Morton's foot syndrome, 265, 435, 436f alignment disorders, 435, 436f-437f Metatarsocuneiform joint, 118, 118f Morton's neuroma, 401, 402t, 412-425 realignment in, 8, 439f arthrodesis of, 279-284 anatomy in, 412, 412f, 4l3f anatomic neck of, 10f, 11 orientation affecting metatarsus primus conservative management of, 416-417, base of, 11 adductus development, 56, 56f 4l6f-417f blood supply to, 35 Metatarsophalangeal joints, 15-17 diagnosis of, 414-416 declination angles, 99, 99f development arthrodesis of, 267-277 distribution by sex, 4l4t from ossification centers, congruous, 117, 117f, 120, 232, 233f etiology and biomechanics of, 413-414, 11 deviated, 117, 117f, 120, 232, 233f 4l4f fifth, 13 fascial structures in, 19-20, 20f histopathology of, 402t, 412-413, 4l4f first, 11-12, 12f. See also First metatarsal fibrous capsule of, 15, 17 injection therapy in, 417, 4l8f bone first, 17 lateral squeeze test in, 415, 4l6f fourth, 13 subluxed, 117, 117f, 120, 232, 233f locations of, 4l4t head of, 11 Metatarsophalangeal ligaments, 10f, 15-17 occurrence of, 415t avascular necrosis of. See Freiberg's collateral, 15, l6f, 17 recurrent, 423 disease plantar, 15, l6f, 17 surgery in, 417-425 resection in plantar lesions, 440, 442f plantar plate of, 15, l6f in adjacent interspaces, 421-422 shapes of, 117-118, 118f suspensory, 16f, 17 complications of, 422-424, 423f length of Metatarsosesamoideal ligaments, l6f, 17 deep transverse intermetatarsal liga comparison of first and second Metatarsus adductus angle, 95-96, 96f, ment in, 419, 421 metatarsals. See Metatarsal protru- 115-117, 116f dissection in, 419, 422f sion, relative Metatarsus primus adductus, 54f, 109, 111 dorsal approach in, 418-419, distal osteotomies affecting, 167 cuneiform osteotomy in, 285, 289, 289f 420f-421f first metatarsal. See First metatarsal development of, 54-60 incisional approaches in, 418, 4l9f bone, length of metatarsocuneiform joint orientation plantar approach in, 418, 420f and Freiberg's disease affecting, 56, 56f reoperation in, 423-424, 424f development, with juvenile hallux valgus, 119 results of, 424t, 424-425 454 Metatarsus primus elevatus, 328, 328f Schink metatarsal spreader in, 419, management of lesser lesions. See and hallux limitus/rigidus formation, 313 421f Lesser metatarsal surgery symptoms of, 415, 415t osteotomies Mulder's sign in Morton's neuroma, 415 proximal, 227-266 Muscles of foot, 20-26 shortening, in Freiberg's disease, 455f-456f, 456 INDEX 577

electromyograph activity of, 50f sural nerve entrapment, 409 overall, 380 in tarsal tunnel syndrome, 406 tarsal tunnel syndrome, 405-406 patient history in, 379-380 extrinsic, 20-23 traumatic, 401 positional digital malalignment in, 382 at first metatarsophalangeal joint, 42, Neurovascular bundle, 19, 20f radiographic assessment in, 384, 385f 43f New's procedure, 561-562, 564 structural, 384-385 intrinsic, 23-26 results of, 563 sway balance testing in, 382-383, 383f testing of, 103 Nutrient arteries of bone, 34, 35f taxicity resistance scale in, 380-382, vascular and nerve supply of, 21t 381t Mygind osteotomy, l64f, 166 visual, 380, 380f O Orthodigital therapy exercises in, 389, 392, 398f N Oblique wedge osteotomy foot gear survey in, 388-389, 393f distal, in tailor's bunion, 466, 466f hallux abducto in, Nail surgery, 481-496 proximal, 243-247, 244f-247f 393, 398f-399f anatomy in, 481, 482f Onychocryptosis, 482-493 padding material in, 386, 387f-389f wrap-around characteristic of matrix etiology of, 482^83 in-shoe temporary test of, 386, 388, in, 491, 493f Fowler procedure in, 491, 491f 390f-392f in direct trauma to nail, 481-482 frontal plane arc of nails in, 483, 483f realignment phase in, 389, 392 in onychocryptosis, 482-493 Frost procedure in, 485, 486f relief and preliminary care in, 385-388 "shoveling" of nail after, 482, 482f Kaplan procedure in, 491 repair phase in, 392-399 subungual exostectomy, 494-495, 495f Lapidus procedure in, 492, 494f splints in, 389, 397f total avulsion for onychomycosis, laser treatment of, 489 hallux night splint, 393, 398f 493-494 nail borders in, 483f traction technique in, 389, 396f Navicular bone, 9f paronychia in, 483-484 urethane mold orthosis in, 389, Necrosis of metatarsal head, avascular. See permanent total nail removal in, 394f-395f Freiberg's disease 490-493 Os intermetatarseum, 14 Nerve sheath tumors, 401 phenol and alcohol matrixectomy in, Ossification Nerve supply to foot, 26-30, 27f 485-488 centers for foot bones, 8t, 8-9 dorsal, 26-28, 27f complications of, 487 of sesamoids, 153, 158 proper digital, 27, 27f, 28, 29-30 improper splitting of nail in, 486, of soft tissue, radiographic features of, to muscles in foot, 21t 487f plantar, 27f, 28-29 postoperative care in, 487-488 89 proper digital, 27f, 28, 29-30 technique in, 486-487 Osteoarthritis, 334f Neurologic evaluation, 103 physical modalities for correction of, arthrodesis of first metatarsocuneiform Neuroma, 401 484 joint in, 280, 280f intermetatarsal plantar sodium hydroxide chemical matrixecto- implant arthroplasty in, 333 between first and second metetarsal my in, 489 radiographic features of, 75-76, 76f heads, 411 spiculectomy in, 488 in erosive disease, 76 between third and fourth metatarsal Suppan nail technique No. 2 in, Osteoarthropathy, hypertrophic, radi heads, 412-425. See also Morton's 491-492, 493f ographic features of, 82-83, 83f neuroma terminal Syme procedure in, 472, 472f, Osteocartilaginous graft procedure, Joplin, 411, 411f 492-493 552-560 Morton, 401, 402t, 412-425. See also wedge resections in, 485, 485f complications of, 555 Morton's neuroma Whitney acisional matrixectomy in, 491, postoperative care in, 555, 560 Neuromatous or N-zone area, 409, 409f 492f results of, 554f, 555, 556f-559f Neuropathies, 401-425, 402t Winograd procedure in, 485, 485f technique in, 553f, 555 deep peroneal nerve entrapment, 410 Zadik procedure in, 490f, 490-491 Osteochondritis, sesamoid, 157f, 158 diabetic, 521-522 Onychomycosis, total nail avulsion in, Osteochondritis dissecans, and hallux limi- diagnosis of, 403-405 493-494 tus/rigidus formation, 313-314, dorsal forefoot nerve injury and entrap ment, 409-410 Opening wedge osteotomy 314f cuneiform, 285 at first metatarsophalangeal joint, Osteoclasis for plantar lesions, 441, 442f proximal, 249-251, 250f-251f 410-411, 411f Osteodesis, distal, of first two metatarsal inferior calcaneal nerve entrapment, Opponens hallucis muscle, 25 bones, 545, 547f 407-409 Orthodigital evaluation, 379-385 Osteomyelitis in acquired deformities, 385 and innervation to leg and foot, 402, after implant arthroplasty, 343 block balance testing in, 383, 384f 402t, 403f-406f of sesamoids, 156, 157f digital line-up technique in, 384-385, mechanical, 401 Osteonecrosis after lateral dissection with Morton's neuroma, 401, 412-425 386f Austin procedure, 176 functional, 380-383, 381t, 382f-384f and peripheral nerve anatomy, 402-403, Osteopenic disorders, radiographic fea- manual, 380, 381f 407f-408f tures of, 86-87, 87f-88f 578 INDEX

Osteophytes deep, 26-28, 402t mobility of metatarsals in, 433-434, 435f dorsal, in hallux limitus, 328, 329f anatomy of, 410f propulsive-phase, 433 production after implant arthroplasty, entrapment of, 410 radiographic assessment of, 438-440, 344 lateral terminal branch, 27-28 44lf Osteosclerosis, radiographic features of, medial terminal branch, 27 stance-phase, 433 84-86, 85f-86f superficial, 27f, 28 Plantar muscles Osteotomy. See also specific osteotomy pro- Peroneus brevis muscle, 22-23 first layer of, 24 cedures vascular and nerve supply to, 21t fourth layer of, 25-26 cuneiform, 285-293 Peroneus longus muscle, 22 second layer of, 24-25 distal, in hallux valgus, 163-167 actions of, 58-60, 60f third layer of, 25 in hallux limitus/rigidus, 334t in hallux limitus/rigidus, 314 Plantar nerves, 402t, 405f, 408f lesser metatarsal, 440-449, 442f affecting first ray stability, 108 entrapment of, 406 complications of, 447f-448f, 449 vascular and nerve supply to, 21t lateral, 27f, 29 metatarsal shortening, in Freiberg's dis Peroneus tertius muscle, 22 medial, 27f, 28-29 ease, 455f-456f, 456 vascular and nerve supply to, 21t Plantar pressure middiaphyseal, 215-224 Petersen procedure, 561, 562f, 564 assessment of, 509-516. See also phalangeal, 137-146 results of, 563 Pressure analysis of foot stress proximal, 227-266 selection chart for, 565f and Freiberg's disease development, in tailor's bunion, 462-469 Phalangeal osteotomy, 137-146. See also 454-455 Overlapping of toes Akin procedure Popliteal lymph nodes, 36 fifth toe, congenital, 374f, 374-375 complications of, 146 Porokeratosis plantaris discreta, 431f, 433 relocation of digit in, 374f, 374-375 fixation of, 137, 139f Porta pedis, 24 second toe, acquired, 375f, 375-376 in juvenile hallux valgus, 121 Porter soft-tissue procedure, 126t relocation of digit in, 375-376, 376f variations of, 139, 144-146, 145f-146f Posterior facet angle, 99 Phalangeal valgus, 536-537, 537f Preoperative assessment, 107-122 P Phalanges of foot, 13-14 clinical evaluation in, 109-110 blood supply to, 35 etiology identification in, 107-109 development from ossification centers, Padding, protective, 386, 387f-389f radiography in, 110-119 13 in-shoe temporary test of, 386, 388, Pressure analysis of foot stress, 509-516 distal, 14 capacitance transducers in, 511-512 390f-392f middle, 13-14 Pain case studies of, 514-516 proximal, 13 clinical applications of, 513-516 arthrometric examination in, 514t Phenol and alcohol nail matrixectomy evaluation of, 103, 109 electronic pressure transducers in, complications of, 487 510-511 in metatarsalgia. See Metatarsalgia in heloma durum of lateral nail groove, in Morton's neuroma, 415, 415t force-sensing resistors in, 513 488, 489f in Freiberg's disease, 454-455 in neuropathies, 401, 403-404 improper splitting of nail in, 486, 487f pressure analysis of foot stress in, historical review of, 509-510 in onychocryptosis, 485-488 magneto resistor sensors in, 513 509-516 postoperative care in, 487-488 in tailor's bunion, 460 piezoelectric transducers in, 512-513 technique in, 486-487 strain gauges in, 512 Palliative methods of treatment, 3 Physical examination, 102-106, 110 Palmar-plantar dyskeratosis, 430, 432f Pronated foot, biomechanical alterations Physical therapy, postoperative, 134 in, 107-108 Parabola angle, metatarsal, 232, 234f after implant arthroplasty, 340-341 Paronychia, 483-484 Prophylactic surgery in diabetic foot, Pirogoff amputation, 480 519-528 Peabody osteotomy, 163, l64f, 183 Plantar arch Pediatric patients. See Juvenile hallux val- Prostheses. See Implant arthroplasty arterial, 34-35 Protrusion measurements, metatarsal, gus venous, 36 Peg-in-hole procedures 10-11, 115, 1l6f, 232, 234f Plantar arteries Proximal osteotomies, 227-266 in digital deformities, 361 deep, 30f, 31, 33 distal, 164f, 166 bone stock quality in, 232, 234f lateral, 31f, 33 compared to Austin procedure, 178 in first metatarsophalangeal joint, 275 proper digital branch, 33 proximal, 258-259, 259f complications of, 264-265, 264f-265f medial, 31f, 33 crescentic or arcuate, 247-249 Perforating arteries marginal, 33 anterior, 32 fixation of, 247, 249, 249f metatarsal, 34 procedure in, 247, 248f posterior, 32, 33 in sesamoid vascular supply, 154 Perineurium, 403 Plantar lesions determination of osteotomy size in, 235, Periosteal capillary plexus, 34-35, 35f digital deformities with, 433, 434f 235f-237f Periostitis, solid, radiographic features of, etiology of, 430-440 dorsilinear skin incision in, 235, 238f 82-83, 83f keratotic, 430-433, 431f-432f double, 251-254 Peroneal nerves, 402t, 403f, 404f, 405f management of, 440-449. See also procedure in, 252f-254f, 253 Lesser metatarsal surgery fixation of, 259-264, 260f-264f INDEX 579

Golden, 227, 254-255, 255f, 266 computed tomographic scanning, in osteopenic disorders, 86-87, 87f-88f hinge axis guide in, 242, 243f, 245f 93-95 partitioned sesamoids in, 158f identification of metatarsocuneiform magnetic resonance imaging, 91-93 in plantar lesions, 438-440, 441f articulation in, 235, 238f, 244f tomography, 90-91 preoperative measurements in, 227-234 intermetatarsal angle in, 227-228, angular relationships in, 119 in psoriatic arthritis, 73-74, 73f-75f 229f-230f articular set angles in recommended approach to, 67-68 Juvara, 243-247, 266 distal, 113, 114f reference views in fixation of, 247, 247f proximal, 111-113, 112f anteroposterior, 68f procedure in, 243-246, 244f-246f tangential, 113, 113f lateral, 68f in juvenile hallux valgus, 121 biomechanical evaluation in, 95-99 in Reiter's disease, 73f, 74-75, 75f Kotzenberg, 256, 257f, 266 in anteroposterior view, 95-98, relative metatarsal protrusion in, 115, Lapidus, 228, 231f, 265 96f-97f 1l6f Lenox-Baker, 256, 258f in lateral view, 98-99, 98f-99f in rheumatoid arthritis, 71-72, 72f, 499, "bone within a bone" appearance in, 84 Logroscino, 227, 251-254, 252f-254f, 503f 266 calcaneal axial view in, 69 in sclerotic disorders, 84-86, 85f-86f Loison and Balacescu, 232, 242 in calcifications, 87-89, 89f in septic arthritis, 78-79 Ludloff and Mau, 255-256, 256f vascular, 89 in sesamoid fractures, 159, 160f, 16lf metatarsal protrusion measurements in, in Charcot joint arthropathy, 79-81, in solid periostitis, 82-83, 83f 232, 234f, 266 79f-81f in spondyloarthropathies, 72-75, metatarsophalangeal joint position in, and criteria for Reverdin procedure, 73f-75f 232, 233f 203, 204f standard bone survey in, 68 neurovascular structures in, 235, 238, and criteria for soft-tissue procedures, in tailor's bunion, 460-461 239f-241f 131 tibial sesamoid position in, 115, 115f peg-in-hole, 258-259, 259f in diffuse idiopathic skeletal hyperosto- in tubular bone disorders preoperative radiographic measure sis, 81-82, 82f decreased diameters, 84 ments in, 227-234 digital assessment in, 384, 385f increased diameters, 83 proximal articular set angle in, 228, 232, forefoot axial view in, 69, 71 pointed deformities, 84 232f in Freiberg's disease, 453, 454f shortened deformities, 84 in gouty arthritis, 76-78, 77f-78f reciprocal planing in, 242 Range of motion Rocyn Jones, 258-259, 259f hallux abductus angle in, 111, 111f in dorsiflexed first ray, 105, 105f hallux abductus interphalangeus angle surgical approach in, 235, 238, evaluation of, 104-105, 110 238f-241f in, 114f, 114-115 normal range in, 104, 110 hallux lateral view in, 69 Trethowan and Stamm, 249 in plantar-flexed first ray, 105, 106f V type, 256, 257f-258f, 266 in hallux limitus/rigidus, 318f, 318-319 quality of, 104, 110 hallux valgus appearance in, 530f wedge and sesamoid function, 155 closing, 242, 242f-243f Harris-Beath view in, 69, 70f in tailor's bunion, 460 in hypertrophic osteoarthropathy, oblique, 243-247, 244f-247f valgus rotation in, 105, 105f opening, 249-251, 250f-251f 82-83, 83f Rearfoot motions affecting metatarsals, in hypertrophy of fibular sesamoid, 159f Pseudoganglion, 27 48-49, 57f, 57-60 Psoriatic arthritis, radiographic features of, intermetatarsal angle in, 111, 111f Recurrence of deformity after soft-tissue 73-74, 73f-75f lateral oblique view in, 68-69, 70f procedures, 134 Pulses in foot and leg, examination of, in lupus erythematosus, 78 Reese osteotomy guide, 274-275 medial oblique view in, 68, 68f 103 Reflexes, evaluation of, 103 Isherwood, 68, 69f Push-up test Regnauld implant, 351-352, 351f after correction of digital deformities, metatarsal head shape in, 117-118, 118f Regnauld enclavement procedure, 567, 370 metatarsal joint articulations in, 117, 567f after Keller arthroplasty, 301, 301f 117f Regnauld osteocartilaginous graft Pyrolytic carbon implant, 357 metatarsocuneiform joint in, 118, 118f procedure, 552-560 metatarsus adductus angle in, 115-117, Reiter's disease, radiographic features of, 1l6f 73f, 74-75, 75f Q in metatarsus primus varus, 109 normal foot in Resection arthroplasties, 295-305, 296t. See Quadratus plantae muscle, 24 pronated, 51f also Arthroplasties, resection supinated, 51f Resistors for pressure assessment, 513 in ossification of soft tissue, 89 Reverdin-Green procedure, 206f, 207 R in osteoarthritis, 75-76, 76f Reverdin-Laird procedure, 207f, 207-208 in erosive disease, 76 modifications of, 208f-209f, 209, 211 Radiography, 67-99, 110-119 in osteochondritis of sesamoids, 157f, Reverdin procedure, 3-4, 163, l64f, in acrolysis, 75f, 84 158 203-212 ancillary modalities in in osteomyelitis of sesamoids, 156, 157f age of patient affecting, 203 580 INDEX

Reverdin procedure (Continued) Sesamoid bones, 14, 42, 153-161 Soft-tissue procedures, 125-134 base wedge osteotomy with, 253 anatomy of, 154, 155f adductor hallucis tendon transfer in, disadvantages of, 204, 207 arterial supply of, 35, 154 130-131, 133 operative technique in, 203-204, 205f disorders of, 155-156 capsulorraphy in, 130 postoperative care in, 204 embryology of, 153-154 capsulotomy in, 127 proximal articular set angle in, 204 fibular, 14 cerclage techniques in, 545-550 radiographic criteria for, 203, 204f release of, 129, 129f complications of, 134 Reverdin-Todd procedure, 210f—211f, removal of, hallux varus from, 129, criteria for, 131-133 211-212 134, 308, 308f Reverse osteotomies fracture of, 159, l60f, l6lf in digital deformities, 359 Austin, 465, 465f functional role of, 156 extensor hallucis brevis tenotomy in, in hallux varus, 311 hypertrophy of, 158, 159f 130 Helal, 567, 567f infection of, 156, 157f extensor hallucis longus lengthening in, Juvara, 243 lateral movement of, 50-52, 51f 130 Rheumatism, severe deformity from, 537f, normal function of, 155 fibular sesamoid release in, 129, 129f 537-538 ossification of, 153, 158 fibular sesamoid removal in, 129, 133 Rheumatoid arthritis, 499-508, 500f-502f osteochondritis of, 157f, 158 hallux varus from, 129, 134, 308, 308f arthroplasty in, 504-508, 505f-507f partitions of, 158f, 158-159 historical aspects of, 125-126 patient selection in, 502 compared to fractures, 159 in Japan, 530-532 preoperative considerations in, etiology of, 158-159 in juvenile hallux valgus, 121 502-504 incidence of, 158 lateral release in, 127-131 biomechanical aspects of, 499-500 pathomechanics of, 155-156 medial eminence resection in, 127, 128f gait in, 500 tibial, 14 objectives of, 126—127 implant arthroplasty in, 333, 335 articulation preservation with angled osseous procedures with, 131, 132f postoperative analyses in, 133-134 juvenile, hallux valgus in, 119 cut, 127, 129f postoperative care in, 507-508 postoperative course in, 134 peaking after medial eminence resec- procedure selection in, 504-507 preservation of tibial sesamoid articula- tion, 129, 130f, 134 radiographic features of, 71-72, 72f, tion in, 127, 129f position measurements, 115, 115f 499, 503f recurrence of deformity after, 134 subluxation after adductor hallucis Richards implant, 351, 351f release of adductor tendons in, 128-129 tendon transfer, 309-310,310f Riedel arthroplasty, 295, 296t techniques in, 127-131 trauma of, 156 Rocyn Jones osteotomy, 258-259, 259f tibial sesamoid peaking in, 129, 130f, Sesamoidectomy, Austin osteotomy with, Rose arthroplasty, 295, 296t 134 176 Roux osteotomy, 163, 164f, 295, 296t prevention of, 127, 129f Sesamoideophalangeal ligaments, l6f, 17 Spiculectomy, nail, 488 biomechanical alterations in, 108 Splayfoot with tailor's bunion, 459 S Sesamoiditis, 156-157 Splints, digital, 389, 397f Shoes hallux night splint, 393, 398f Sagittal plane V sliding osteotomy in tai- adjustments after hallux amputation, Spondyloarthropathies, radiographic features lor's bunion, 465, 465f 475f of, 72-75, 73f-75f Salvage procedures in hallux affecting shape of foot, 40f Stein soft-tissue procedure, 126t limitus/rigidus, 333, 334t and hallux valgus formation, 1, 2, 39- Steindler stripping of os calcis, 147, 148 Saphenous nerve, 26, 27f, 404f 41, 60-61, 6lf, 541, 541t Strain gauges, 512 Saphenous vein, lesser, 36 and Morton's neuroma development, Stress assessment under pathologic forefoot, Scarf-Meyer Z osteotomy, 221-224, 414 509-516. See also Pressure analysis 222f-224f postoperative fitting of, 539 of foot stress Schede soft-tissue procedure, 126t selection of, 388-389, 393f Subtalar joint pronation, and tailor's Schink metatarsal spreader, 419, 421f test of padding material in, 386, 388, bunion, 459-460 Schwann cells, 402 390f-392f Suppan nail technique No.2, 491-492, 493f Sciatic nerve, 405f Shortening metatarsal osteotomy in Sural nerve, 28, 403f, 405f Sclerotic disorders, radiographic features Freiberg's disease, 455f-456f, 456 entrapment of, 409 of, 84-86, 85f-86f "Shoveling" of nail, postoperative, 482, Swanson implants Second metatarsal bone, 12 482f in hallux limitus/rigidus, 324-325 infraction of. See Freiberg's disease hemi-implants, 330, 331t, 345, 347, 349, Second toe overlap, acquired, 375f, Silicone implants, 327, 330 host reactions to, 344 349f 375-376 titanium, 354, 354f relocation of digit in, 375-376, 376f Silver bunionectomy, 125, 131, 132-133 hinged, 350f, 350-351 Seeburger implant, 347-349, 348f Simmond osteotomy, 542t, 543 Skeletal structure of foot, 9f, 9-14 titanium grommets for, 345, 350, 351f Septa Skin examination, 103 in Japan, 536, 536f intermuscular, medial and lateral, 23 Sodium hydroxide chemical matrixectomy placement of, 339f sagittal, 19 in onychocryptosis, 489 in rheumatoid arthritis, 504 total, 331, 331t, 345

INDEX 581

Sway balance testing, 382-383, 383f interosseous, 15 Tuberculous arthritis, radiographic features Syme amputation, 480 plantar, 15 of, 79 terminal, 472, 472f, 492-493 Tarsometatarsal synovial membranes, 15 Tubular bone disorders, radiographic fea- Syms soft-tissue procedure, 126t Taxicity resistance scale, 380-382, 381t tures of, 83-84 Syndactylization of fourth and fifth toes in Tendons of foot Tumors of nerve sheath, 401 severe recurring heloma molle, bowstringing of, 20, 53 Turk's test in tarsal tunnel syndrome, 406 363-365, 365f at first metatarsophalangeal joint, 42-44, Synovial cavities, interphalangeal, 18 44f Synovial membranes transfers in digital deformities, 359 U metatarsophalangeal, 17 Tenopexy in Keller arthroplasty, 297—298, Ulcerations in diabetic foot, 520-521 tarsometatarsal, 15 298f with neuropathic edema, 522 Third metatarsal bone, 13 Synthes Cannulated Screw System, Urethane mold orthosis, 389, 394f-395f 150-151 Third ray, long, 435, 436f Thyroid acropachy, radiographic features of, 83 V T Tibial artery, posterior, 32 V osteotomy Tailor's bunion, 459-469 Tibial nerve, 402t, 405f Austin, 164f, 166-167, 169-180, 562, clinical evaluation in, 460 posterior, entrapment of, 405-406, 408f Tibial sesamoid, 14 564 etiology of, 459-460 distal, in plantar lesions, 442f, 444, 445, fourth intermetatarsal angle in, 460-461, articulation preservation with angled cut, 127, 129f 446f 46lf peaking after medial eminence resec- proximal, in plantar lesions, 442f, idiopathic, 460 tion, 129, 130f, 134 444-445 Keller arthroplasty adaptation in, 462, prevention of, 127, 129f sliding, sagittal plane, in tailor's bunion, 463f position measurements, 115, 115f 464, 465f lateral deviation angle in, 461, 46lf subluxation after adductor hallucis transverse, in plantar lesions, 444, 445 lateral exostectomy in, 462, 462f tendon transfer, 309-310, 310f Vogler offset, 169, 170f osteotomies in, 462-469 Tibialis anterior muscle, 20-22 Valgus rotation of hallux, 105, 105f closing wedge, 466, 466f vascular and nerve supply to, 21t Valleix phenomenon in neuropathies, 404 distal oblique wedge, 466, 466f Tibialis posterior muscle, 23 Hohmann, 463, 464f Tilt-up osteotomy in plantar lesions, 442f, of fifth toe, 371-374 Mitchell, 464, 465f 443-444 arthroplasty with phalangeal head reverse Austin, 465, 465f Tinel's sign in neuropathies, 404 resection in, 372f, 372-383 sagittal plane V sliding, 465, 465f Tomography, 90-91 middle phalangectomy in, 373f, transpositional Z, 468-469, 467f-468f disadvantages of, 90 373-374 Wilson, 463-465, 464f indications for, 90-91 of great toe. See Hallux varus pain in, 460 Trabecular pattern, coarsened, disorders tailor's bunion in, 460 radiography in, 460-462 with, 90 Vasculature of foot, 30f-31f, 30-36 range of motion in, 460 Track-bound joints, 104 arterial supply, 30f-31f, 30-36 splayfoot with, 459 Traction therapy, digital, 389, 396f to sesamoids, 35, 154 subtalar joint pronation in, 459-460 Transducers for pressure assessment calcifications in, radiographic features Weisberg and Amberry arthroplasty in, capacitance, 511-512 of, 89 462, 463f electronic, 510-511 embryonic development of, 7-8 Talocalcaneal angle, 96f, 96-97 piezoelectric, 512-513 examination of, 102-103 lateral, 98-99, 99f Transmetatarsal amputation, 477-478, lymphatics, 36 Talocuboid angle, 96, 97 477f-478f in muscles, 21t Talometatarsal angle, 99 Transverse osteotomy, l64f, 166 pathology in diabetic patients, 522 Talonavicular angle, 96f, 97 Transversus pedis muscle, 25, 44 venous return, 35-36 Talonavicular articulation measurements, Trauma Veins of foot, 35-36 97 and Freiberg's disease, 453-454 Venous arch Talus, 9f of nails, management of, 481-482 dorsal, 35 declination angle of, 98, 99f neuropathies from, 401 plantar, 36 Tarsal arteries, 30, 31 sesamoid, 156 Verruca plantaris, 432f, 433 Tarsal tunnel syndrome, 405-406 fractures in, 159, 160f, 16lf Vogler offset V osteotomy, 169, 170f Trethowan procedure, 562-563 anatomy in, 408f results of, 563 management of, 406 selection chart for, 565f W Tarsometatarsal joint, 14 Triangular forefoot Warts, plantar, 432f, 433 Tarsometatarsal ligaments, 14-15 convex, 436 Watermann procedure in hallux dorsal, 14 flat, 431f, 436, 439f limitus/rigidus, 323, 323f 582 INDEX

Wedge osteotomy Wilson osteotomy, 164f, 165-166, 183, 188 modifications of, 223-224 closing in China, 542t operative technique in, 223, 223f cuboid, cuneiform osteotomy with, in tailor's bunion, 463-464, 464f postoperative care in, 224 291, 291f Winograd procedure in onychocryptosis, preoperative radiographs in, 223 cuneiform, 285 485, 485f short, 224, 224f proximal, 242, 242f-243f Wyss implant, 355 transpositional, in tailor's bunion, 465, oblique 467f-468f distal, in tailor's bunion, 464-465, Zadik procedure in onychocryptosis, 490f, 466f Y 490-491 proximal, 243-247, 244f-247f ZMR toe prosthesis, 354 opening Youngswick osteotomy for metatarsus cuneiform, 285 primus elevatus, 169, 170f proximal, 249-251, 250f-251f Wedge resections in onychocryptosis, 485, 485f Z Weight-bearing loads during foot motion, 56-58, 59f Z-type osteotomy, 221-224, 222f Weil implant, 330-331, 331t, 335, 352, 352f advantages and disadvantages of, 224 Whitney acisional matrixectomy in ony- indications for, 223 chocryptosis, 491, 492f Ishizuka, 534-536, 535f-536f