Abstract：
:There is a paucity of information on adult coalitions without large, well-designed outcome studies. Current recommendations are thus similar to those for adolescents. Based on the available literature, current recommendations include an initial trial of adequate nonoperative treatment in symptomatic coalitions. Unlike adolescent coalitions, nonoperative treatment may be even more effective in the adult patient as many are asymptomatic or discovered after injury. If nonoperative treatment fails, then surgical intervention is considered and tailored to the location of the coalition, existing advanced arthrosis, and any existing deformity. Similar to the adolescent, surgical treatment for adult calcaneonavicular coalitions typically involves an attempt at resection with some type of interposition. Resection can be attempted for talocalcaneal coalitions that do not present with advanced arthrosis or significant hindfoot malalignment. For those patients with advanced arthrosis, more than 50% involvement of the joint hindfoot malalignment, subtalar or triple arthrodesis is recommended. The decision between resection and arthrodesis is controversial in the adolescent population. With few outcome studies in adults, it is even more difficult to make definitive treatment recommendations; however, the indications for resection are likely even more limited. It is likely that the adult subtalar coalition that becomes symptomatic and fails nonoperative treatment will require arthrodesis for full pain relief and improvement in objective outcome measures, such as the AOFAS hindfoot score. Our treatment algorithm focuses first on a trial of nonoperative treatment of at least 3 months regardless of coalition location. After failed nonoperative treatment, calcaneonavicular coalitions are in most cases treated with excision and interpositional fat graft. For talocalcaneal coalitions, resection is offered to patients with neutral hindfoot alignment, some preservation of subtalar joint motion and no adjacent joint arthrosis. The patients are advised that the outcome after resection of talocalcaneal coalitions is less predictable than resection of calcaneonavicular coalitions. Those patients with absent subtalar motion and relatively normal hindfoot alignment are candidates for in situ fusion of the subtalar joint. For those patients with greater than 15° of valgus hindfoot malalignment on a weight-bearing hindfoot alignment view or adjacent joint arthrosis, a triple arthrodesis is recommended with or without medial displacement osteotomy of the calcaneus. Adjacent joint arthrosis may be determined by radiographs, CT scan, or preoperative MRI.
journal_name
Foot Ankle Clinjournal_title
Foot and ankle clinicsauthors
Thorpe SW,Wukich DKdoi
10.1016/j.fcl.2012.03.004subject
Has Abstractpub_date
2012-06-01 00:00:00pages
195-204issue
2eissn
1083-7515issn
1558-1934pii
S1083-7515(12)00021-6journal_volume
17pub_type
杂志文章,评审abstract：:Nonunions of the tibia represent challenging orthopedic problems, which require the surgeon to analyze numerous factors and choose an appropriate treatment. Tibial nonunion treatment requires establishing its existence and cause. The treatment algorithm necessitates consideration of a wide variety of factors: the loca...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2005.12.003
更新日期：2006-03-01 00:00:00
abstract：:There are more than 150 different procedures described for correction of the hallux valgus deformity, the treatment of which is usually guided by severity. Moderate to severe hallux valgus has traditionally been managed with a shaft or proximal osteotomy together with distal soft-tissue release. Proximal osteotomies c...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2014.02.004
更新日期：2014-06-01 00:00:00
abstract：:Tarsometatarsal (TMT) joint complex injuries can be caused by either direct or indirect injuries. The Lisfranc joint represents approximately 0.2% of all fractures. Up to 20% of these injuries are misdiagnosed or missed on initial radiographic assessment; therefore, a high index of suspicion is needed to accurately di...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2018.07.014
更新日期：2018-12-01 00:00:00
abstract：:Cavovarus foot deformity is a result of a dysbalance of the extrinsic musculature about the foot. Because of the multi-articular bony structure of the foot and ankle, the slightest imbalance of muscular forces causes osteo-articular malalignment and consequent gross deformities. This article discusses hindfoot issues ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2008.02.005
更新日期：2008-06-01 00:00:00
abstract：:Triple arthrodesis is largely used to restore painful hindfoot deformity. However, the procedure has been connected to several postoperative complications. Therefore, an isolated fusion of the talonavicular and the subtalar joint through a single medial approach has gained popularity. This "diple" arthrodesis provides...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2010.11.006
更新日期：2011-03-01 00:00:00
abstract：:Foot and ankle reconstruction following blast trauma is particularly challenging based on the devastating soft tissue injuries associated with open comminuted fractures. Considering the difficulties encountered in reconstruction, the functional limitations associated with many salvaged limbs, and the superior performa...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2005.10.002
更新日期：2006-03-01 00:00:00
abstract：:Acute injuries to the lateral ankle complex remain common and account for 20% to 25% of musculoskeletal injuries. Initial assessment should use the Ottawa ankle rules, and grading should take into account degree of mechanical instability. Nonoperative measures are preferable for all grades of injury; however, mechanic...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2018.07.001
更新日期：2018-12-01 00:00:00
abstract：:Lateral talar process fractures (LTPF) are uncommon injuries but have become more relevant with snowboarding. Currently the fractures are classified according to McCrory-Bladin into 3 types, with advice for treatment that is not ideal anymore. This article proposes modifying the existing classification by differentiat...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2018.04.009
更新日期：2018-09-01 00:00:00
abstract：:There are many psychologic effects to trauma and disease. Patients often exhibit a grief reaction and loss of identity in the early stages of recovery. Fear and anxiety about the physical condition and future independence can contribute to feelings of separation and loneliness in patients. Loss of self-confidence and ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/s1083-7515(03)00100-1
更新日期：2001-06-01 00:00:00
abstract：:Ankle replacement results may be compromised by malposition of the components. An anterior displacement can be measured on a lateral standing radiograph. The ankle may appear anteriorly translated because the ankle is overstuffed, the heel cord is tight, or the posterior capsule is tight. In ankle instability with deg...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2017.01.014
更新日期：2017-06-01 00:00:00
abstract：:Postoperative recurrence of hallux valgus is a relatively common complication and is associated with unsatisfactory surgical outcomes. Risk factors for postoperative recurrence include a round lateral edge of the first metatarsal head (a positive round sign) and incomplete reduction of the sesamoids. These risk factor...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2018.01.006
更新日期：2018-06-01 00:00:00
abstract：:Sonography of the foot and ankle is a quick, relatively inexpensive imaging modality that can be used to diagnose a variety of pathologic conditions. Sonography is particularly well suited for the assessment of tendons, soft-tissue masses, and suspected foreign bodies. Visualization of internal structural detail typic...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：:Peroneal tendoscopy is indicated for peroneal tenosynovitis, subluxation or dislocation, snapping, partial tears requiring debridement, and postoperative adhesions and scarring. Peroneal tendoscopy was also found to be valuable as a diagnostic tool in some instances. It is generally reported to have good to excellent ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2014.10.011
更新日期：2015-03-01 00:00:00
abstract：:Hallux rigidus or osteoarthritis of the first metatarsophalangeal joint is characterized by pain, stiffness of the joint, and alterations of gait. The appeal of joint arthroplasty for hallux rigidus is similar to its benefits in other joints in the body. The ideal implant should relieve pain, restore motion, improve f...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2008.11.009
更新日期：2009-03-01 00:00:00
abstract：:Although Achilles tendinopathy has been extensively studied, there is a clear lack of properly conducted scientific research to clarify its etiology, pathology and optimal management. Emerging non-operative management and heavy load eccentric strengthening protocols based on these theories have yielded encouraging ear...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2005.01.007
更新日期：2005-06-01 00:00:00
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journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2010.02.004
更新日期：2010-06-01 00:00:00
abstract：:Injuries to the ankle, foot, and toes of injured workers are common. Although the workers' compensation system attempts to collect information about these injuries and report them in a meaningful way, the process is somewhat inconsistent, inaccurate, and provides information relevant to government agencies but not to ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/s1083-7515(02)00028-1
更新日期：2002-06-01 00:00:00
abstract：:Distal tibial osteotomy is an effective treatment for a variety of pediatric and adult foot and ankle disorders. Exposure osteotomies provide access to the tibiotalar joint for such problems as talar body fractures and osteochondral lesions of the talus. The channel osteotomy provides improved access to posterior tala...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/s1083-7515(03)00115-3
更新日期：2001-09-01 00:00:00
abstract：:Approximately 3% of osseous tumors occur in the foot and ankle. Solitary bone cysts, chondroblastoma, intraosseous lipoma, osteoid osteoma, chondrosarcoma, and Ewing's sarcoma seem to have a predilection for the calcaneus. Biopsy is often a crucial step in management. Tumor-like conditions, such as cysts, reactive les...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2005.05.002
更新日期：2005-09-01 00:00:00
abstract：:Posteromedial ankle complaints are most often caused by a disorder of the posterior tibial tendon. Two predominant groups of patients can be distinguished: the first involves younger patients who have some form of systemic inflammatory disease; the second involves older patients whose dysfunction is caused by chronic ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章
doi：10.1016/j.fcl.2006.03.001
更新日期：2006-06-01 00:00:00
abstract：:Osteochondral lesions of the talus can present a challenge to the orthopedic surgeon. Because of its avascular nature, articular cartilage has a poor capacity for self-repair and regeneration. A wide variety of strategies have been developed to restore the structure and function of injured cartilage. Surgical strategi...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2012.12.005
更新日期：2013-03-01 00:00:00
abstract：:Considerable recent orthopedic literature is dedicated to either the surgical management of OLTs and correction of varus ankle alignment, but little is published on the combination of these 2 problems. We anticipate that future clinical and biomechanical research will address their simultaneous treatment; until then, ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2011.11.011
更新日期：2012-03-01 00:00:00
abstract：:Flexor to extensor transfer is a useful means for the correction of a flexible hammer toe deformity. Although satisfaction rates have varied in the literature, this technique remains a useful tool in the surgeon’s armamentarium to improve toe deformity, decrease pain, and aid in shoe wear. ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章
doi：10.1016/j.fcl.2011.08.005
更新日期：2011-12-01 00:00:00
abstract：:The understanding of the pathology and treatment of hallux sesamoid disorders has improved considerably over the last few decades. It is interesting to speculate what further improvements are on the horizon. Newer imaging methods and possibly an increased use of small joint arthroscopy may make it possible to better d...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：
更新日期：2000-09-01 00:00:00
abstract：:Ankle joint distraction has been shown to be a viable alternative to ankle arthrodesis or ankle replacement. The à la carte approach to ankle joint preservation (resection of blocking osteophytes, release of muscle/joint contractures, and realignment osseous ankle procedures) presented in this article as important for...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2008.05.001
更新日期：2008-09-01 00:00:00
abstract：:The paralytic drop foot represents a challenging problem for even the most experienced orthopedic surgeon. Careful patient selection, thorough preoperative examination and planning, and application of tendon transfer biomechanical and physiologic principles outlined in this article can lead to successful results, eith...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2013.12.002
更新日期：2014-03-01 00:00:00
abstract：:Salvage of nonunion and malunion of trauma of the foot and ankle is often challenging surgery. Internal fixation provides the mainstay of most orthopedic surgeons' treatment of these conditions. Patient systemic factors, local factors, and the complex nature of these often multiplanar deformities may make external fix...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2009.03.007
更新日期：2009-09-01 00:00:00
abstract：:Surgical decompression of peripheral nerves for the treatment of diabetic peripheral neuropathy has been studied and previously reported. These studies reported decreased pain and some studies showed improved sensory function. The role that this surgery can play remains controversial. ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2003.12.001
更新日期：2004-06-01 00:00:00
abstract：:Interdigital neuralgia affects a significant number of individuals, with an average age of presentation in the sixth decade and a 4- to 15-fold increased prevalence in women. Historical descriptions date back to the 19th century. Nonoperative treatment with shoe modifications, metatarsal pads, and injections provides ...
journal_title：Foot and ankle clinics
pub_type： 杂志文章,评审
doi：10.1016/j.fcl.2011.01.010
更新日期：2011-06-01 00:00:00
abstract：:Amputations of the lower extremity may result from several etiologic factors. Most amputations performed in the United States result from a dysvascular limb. A majority of the population with vascular impairment comprises people with diabetes. These individuals frequently have comorbidities that may also affect the ul...
journal_title：Foot and ankle clinics
pub_type： 杂志文章
doi：10.1016/j.fcl.2010.05.001
更新日期：2010-09-01 00:00:00
