Cumulative Index 2004

Cummulative Index 2004

A

Ab fibers, in diabetic neuropathy, 224–225

Abduction, in peritalar joint biomechanics, 664

Abduction deformities, of midfoot, fusion andexternal fixation for, 534–535

Accessory navicular, 165–180anatomy of, 4, 18–20

classification based on, 166–168clinical presentations of, 170–171conservative management of, 173–174fractures of, 31–32, 50–51historical descriptions of, 165–166imaging of, 171–173, 184–185

symptomatic, 186–188incidence of, 165pathologic implications of, biomechanics

and, 169–170histology and, 168–169potential of, 166

posterior tibialis tendon relationship to,165–166pathologic states of, 168–169

surgical treatment of, 174–179complications of, 179excision procedures, 179for fractures, 50–51tendon relocation procedures,

174–178type I, 18, 167, 174

imaging of, 186–187type II, 19, 167, 174

imaging of, 186–188subtypes of, 20, 167–168

type III, 19, 168surgical treatment of, 178–179

type IIII, imaging of, 186–187vascularization of, 21

Accutrac screw, for osteochondral autologoustransplantation, of talus, 740–741

Acetabulum pedis, anatomy of, 4–5, 12in Muller-Weiss disease, 112–114in transverse tarsal joint, 128–129

Acetaminophen, for chronic pain management,375–376

Achilles contractures, in joint distraction, forankle osteoarthritis, 546, 549–550

Ilizarov technique versus,571–572, 578

Achilles tendon, in sural nerve entrapment,264–266in tendon transfers, for paralytic

deformity, 321–322lengthening of, for foot and ankle

fusions, 530, 534

Activity modification, for os trigonum, 790

Acute ankle trauma, external fixation in,455–474, 583–594

anatomic particularities, 583for malleolar fractures, 470–471for tibial pilon fractures, 455–470

complications of, 467–469evaluation of, 456–459evolution of, 455–456goals of, 459–460

1083-7515/04/$ – see front matter D 2004 Elsevier Inc. All rights reserved.

doi:10.1016/S1083-7515(04)00090-7 foot.theclinics.com

Volume 9

March THE NAVICULAR, pages 1–220

June INNOVATIONS IN PERIPHERAL NERVE PROBLEMS, pages 221–432

September EXTERNAL FIXATION TECHNIQUES FOR THE FOOT AND ANKLE,

pages 433–662

December THE TALUS, pages 663–837

Note: Page numbers of article titles are in boldface type.

Foot Ankle Clin N Am

9 (2004) 797–837

results of, 469–470techniques for, 459–467

conventional, 459–462hybrid, 462–467innovative, 646

functional particularities, 583indications for, 638

osteoarticular structure lossas, 584–587

soft tissue reconstruction byflaps as, 591–593

soft tissues jeopardized as,584–587

unstable reduction ofdislocations as,587–591

innovative strategies for, 646limitations of, 639traumatic consequences and,

583–584, 592–593treatment goals of, 584, 592–593

Acute pain, definition of, 373

Adduction, in peritalar joint biomechanics, 664

Adduction deformities, of midfoot, fusion andexternal fixation for, 534–535

Advanced glycation end products (AGEs), indiabetic neuropathy, 231

Aerobic activity, bone formation with, 438

Air bags, vehicular, talar neck fractures and,724–725

Alcohol-induced osteonecrosis, of talus, 749

Aldose reductase pathway, in diabeticneuropathy, 230–231

Alignment, correction for ankle osteoarthritis,546, 549–550effect on talocalcaneal joint, kinematics,

672–674kinetics, 676–677

effect on talonavicular joint, kinematics,674–676kinetics, 677–678

in anterior ankle subluxation control,449–453

innovative distal tibia frame designs for,640–642

Allodynia, with diabetic neuropathy,225–226, 228

Allografts, interpositional, in metatarsallengthening, 559, 562–564, 568nonvascularized, of talus, for avascular

necrosis, 763–765osteochondral, for stage 4 osteochondral

lesions of talus, 743

vascularized, of talus, for avascularnecrosis, 765–768

Alpha-adrenergic agonist, interaction withregional anesthesia, 358–359

Amide anesthestics, interaction with regionalanesthesia, 356

Amputation, for chronic intractable lowerextremity pain, 315tibiocalcaneal arthrodesis as alternative

to, 781–782

Analgesia, postoperative, regional anesthesiafor, 350, 352–353

Anderson’s technique, for anterior anklesubluxation fixation, 449, 451

Anesthesia, amide, interaction with regionalanesthesia, 356injectable. See Local anesthetics (LAs).of lower extremity. See also Regional

anesthesia (RA).for botulinum toxin injection,

340–341general, regional anesthesia

versus, 350

Anesthesia controlled time (ACT), minimizingwith regional anesthesia, 349, 351–352

Anesthesia dolorosa, 306

Angulation, distal tibia external frame designsfor, 640–642in deformity measurement, 492–500

Angulation correction axis (ACA), indeformity analysis, 500–507

osteotomy rules based on, 501–504principles of, 500–501

Animal studies, on surgical decompression, fordiabetic neuropathy, 242–243

Ankle/foot deformity, supramalleolarosteotomy for, 475–487

arthritis and, 476–477complications of, 486congenital deformities, 475–476developmental deformities,

475–476indications for, 477–479operative technique, 484–485outcomes of, 485–486preoperative planning for, 481–484principles of correction, 479–481

tarsal tunnel syndrome from, 274–275with Charcot arthropathy, external

fixation of, 597–598, 602–604

Ankle foot orthosis (AFO), for transverse tarsaljoint control, 142–143

Cummulative Index / Foot Ankle Clin N Am 9 (2004) 797–837798

Ankle joint (AJ), alterations in Muller-Weissdisease, 116–117anatomy of, 663–664distraction arthroplasty of, biomechanics

of, 442–443nerve blocks of, 366–367

modified three-point technique for,368–370

trauma to. See Acute ankle trauma.

Ankle osteoarthritis (AO), from externalfixation, of tibial plafond injuries, 470joint distraction for, 541–553

alternative treatments versus,541, 552

biomechanics and biology of,442–443

clinical results of, 543–545complications of, 552functional outcomes of, 544–545,

551–552indications for, 545, 639innovative strategies for, 643,

645–646pathophysiology of, 541–542pearls and pitfalls of, 549–552postoperative care for, 549scientific rationale for, 541–543serial radiographs of, 548–550surgical technique for, 545–549weight bearing with, 541,

543–545, 550–551supramalleolar osteotomy for, 477–478

Anterior ankle subluxation, external fixationof, 449–453

Anderson’s technique for, 449, 451indications for, 449recent innovative technique for,

449–450, 453

Anterior tarsal tunnel syndrome, 256–261complete versus partial, 258compression sites, 258conservative treatment of, 260deep peroneal nerve anatomy, 256–257

variations in, 257etiology of, 257–258evaluation of, 258–260

clinical, 258–259differential diagnosis, 259–260electrodiagnostic testing, 260imaging in, 260patient history, 258

introduction to, 256surgical treatment of, 260–261

Anterolateral incisions, for talus arthroscopy,706–707

Anteromedial incisions, for talus arthroscopy,706–707

Anteroposterior (AP) radiography view, ofnavicular, 182–183

for stress fracture, 91, 190–194

Anti-inflammatory drugs, for tarsal tunnelsyndrome, 280

Antiarrhythmics, for chronic pain management,399–400

Antibiotics, intravenous, for malleolarfractures, 471PMMA bead indications, 464, 593, 639

Antidepressants, for chronic pain management,395–398

categories of, 397dopamine reuptake, 397–398dopamine reuptake inhibitor, 398mechanisms of, 395–397noradrenergics, 398norepinephrine reuptake, 397–398norepinephrine reuptake

inhibitor, 398selective serotonin reuptake

inhibitors, 397serotonin 2 receptor antagonism, 398serotonin reuptake, 397–398serotonin reuptake inhibition, 398specific serotoninergic, 398

Antiepileptics, for chronic pain management,380–384

carbamazepine, 381felbamate, 384gabapentin, 381–382lamotrigine, 382–383oxacarbazepine, 384phenytoin, 380–381pregabalin, 384tiagabine, 383topiramate, 383valproic acid, 381

Arch supports, for transverse tarsal jointcontrol, 140

Artery(ies), of talus, 776neck, 724–725osteonecrosis and, 746–749

Arthritis. See also Ankle osteoarthritis (AO).of talus, imaging of, 693

post-talectomy, 778–780, 782with fractures, 713, 718–719, 721with talar neck fractures, 726,

734–735of transverse tarsal joint, 134–135supramalleolar osteotomy for, 475–487

complications of, 486congenital deformities and,

475–476deformity connection, 476–477

Cummulative Index / Foot Ankle Clin N Am 9 (2004) 797–837 799

developmental deformities and,475–476

indications for, 477–479operative technique, 484–485outcomes of, 485–486preoperative planning for, 481–484principles of correction, 479–481

Arthrodeses, ‘‘beak’’ triple in IIizarovtechnique, for clubfoot deformitycorrection, 576effect on peritalar joint biomechanics,

ankle joint, 678–679calcaneocuboid joint, 679–681combined procedures, 679–681talocalcaneal joint, 679talonavicular joint, 679

external fixation techniques for, 529–539cavus foot and, 615Charcot arthropathy and,

534–535, 599chronic osteomyelitis and, 533fixator devices for, 530–533literature review of, 529midfoot stabilization with,

533–537osteomyelitis as indication, 536osteoporosis as indication,

532–533pin placement, 530postoperative care, 531revision procedures, 533salvage of midfoot, 533tibiotalar joint exposure, 529–530tibiotalar joint positioning, 530

malunion of ankle, supramalleolarosteotomy for, 478–479

of talus, for avascular necrosis, 768–771complications of, 771

for stage 4 osteochondral lesions, 743for talar neck fractures, 726talectomy for, 775, 778–782

fixation techniques with, 780–781,783–784

of the navicular, 73–83as fracture treatment, 57–60, 102complications of, 81–82

adjacent joint arthrosis as, 82malalignment as, 81–82nonunion as, 81, 102

goals of, 73, 82indications for, 73–74, 82results of, 75–81talonaviculocuneiform. See also

Talonavicular-cuneiform(TNC) arthrodesis.for acute neuropathy,

158–160for chronic neuropathy,

159–161

for Muller-Weiss disease,65–72

technique for, 74–75, 82triple, for paralytic deformity, tendon

transfers versus, 327–328

Arthrography, nuclear medicine enhanced, fortalus pathology, 691–693

Arthrogryposis, in clubfoot deformity, Ilizarovtechnique correction of, 581talectomy for, 775, 777–778

Arthropathy, diabetic neuropathic, talectomyfor, 780–781

Arthroplasty, distraction. See Joint distraction.supramalleolar osteotomy for, 478total ankle, anterior ankle subluxation

control and, 449–453innovative strategies for, 645–646

Arthroscopy, for debridement, of ankleosteoarthritis, 541, 545, 549of talus, 705–707

for arthrodesis of avascularnecrosis, 768–769

for debridement of stage 4osteochondral lesions,705, 737–738

for os trigonum management, 707,791–792

Articular cartilage, degeneration of, 541–542.See also Ankle osteoarthritis (AO).of talus, 775–776

Articular surfaces, in os trigonum, 788of talus, 775–776shapes in kinematics of, in talocalcaneal

joint, 664–665in talonavicular joint, 667–668

ATPase activity, in diabetic neuropathy,240–241

Atrophy, muscular, with peripheral nerveentrapments, 255–256, 258–259

Autogenous bone grafts, in metatarsal length-ening for brachymetatarsia, 14, 559–564

Autograft, nonvascularized, of talus, foravascular necrosis, 761–763

Autologous chondrocyte transplantation(ACT). See also Osteochondralautologous transplantation (OATS).for stage 4 osteochondral lesions of

talus, 738

Autonomic diabetic neuropathy, 222–223

Avascular necrosis (AVN), of talus, 757–773.See also Osteonecrosis.

arthrodeses for, 768–771complications of, 771


core decompression results,760–761

core decompression technique, 760current treatment options,

757–759, 772imaging of, 687, 693–694nonvascularized allograft for,

763–765nonvascularized autograft for,

761–763salvage procedures for, 768–771vascularized bone graft for,

765–768with fractures, of talar neck, 724,

726, 731–732, 734–735treatment algorithm for,

757–758of tibia, supramalleolar osteotomy

for, 479talectomy for, 775, 778, 783with navicular fractures, 61

Avulsion fractures, of navicular bone, 28imaging of, 190operative treatment of, 41–43

Axes of rotation. See also Rotation.in hindfoot, 664in talocalcaneal joint, 665–666in talonavicular joint, 668–670

Axial loading, in external fixator design,434–436in talar body fractures, 714in talar neck fractures, 725navicular bone injuries from, 28, 33tibial pilon fractures from, 455–456

Axial traction, for tibial pilon fractures, 460

B

Baclofen, intrathecal, for complex regionalpain syndrome, 411

Ball and socket ankle, supramalleolarosteotomy for, 479

Bar-to-bar clamp, for anterior anklesubluxation control, 449–452

Barrel hoop plating, for midfoot injuries,625–626

advantages of, 625, 635–636complications of, 635illustrative case, 633–635indications for, 627, 636postoperative management of,

633–635principles of, 626–627surgical technique for, 631, 633

‘‘Beak’’ triple arthrodesis, in Iizarov technique,for clubfoot deformity correction, 576

Benchmarking, for regional anesthesia,354, 371

Benzodiazepines (BZDs), interaction withregional anesthesia, 355

Benzothiazine derivates, for chronic painmanagement, 377

Bicolumn injury mechanism, in navicular bodyfractures, 49–50

Bifurcate ligament, anatomy of, 11–14

‘‘Biologic plating,’’ principles of, 626–627

Biomechanics, of accessory navicular,169–170of diabetic neuropathy, 241–242of external fixation, 433–448

ankle joint distraction arthroplastyand, 442–443

distracted bone histology and,437–441

fixator characteristics, 433–436Ilizarov technique, 434, 436–437limb lengthening forces, 437soft tissue response to distracted

bone, 441–442of Muller-Weiss disease, 111–112of peritalar joint, 663–683. See also

specific joint.alignment effects on, 672–678anatomy of, 663–664, 681–682ankle joint fusion effects on,

678–679axes of rotation, 664calcaneocuboid joint fusion effects

on, 680–681combined arthrodeses effects

on, 681joint fusion effects on,

678–681normal, 664–672

talocalcaneal joint, alignment effecton, 672–674, 676–677joint fusion effects on, 679normal, 664–667, 670–672

talonavicular joint, alignment effecton, 674–678joint fusion effects on,

679–680normal, 667–670

of tarsal navicular, 85–86, 88of transverse tarsal joint, 130–134

after arthrodesis, 134–135

Bipartite navicular, 107–108imaging of, 184–186


Bisector line, transverse, in center of rotationof angulation, 501, 503

Blair arthrodesis, of talus, for avascularnecrosis, 769, 778

Blix curve, of tendon transfers, for paralyticdeformity, 323

Blood supply, bone regrowth and,438–439, 442in tarsal navicular stress fractures, 86to talar neck, fractures and, 724–725to talus, 776

osteonecrosis and, 746–749

Bohler-Braun frame, calcaneal traction with,for tibial pilon fractures, 460

Bone distraction. See alsoDistraction osteogenesis.biomechanics of, 437–439histology of, 439–441

Bone formation/morphology, delay in tarsalnavicular, Muller-Weiss disease from,110–112distraction-stimlulated, 438–441of navicular and periarticular structures,

1–4anterior aspect, 1, 3dorsal aspect, 3lateral end, 4medial end, 4plantar aspect, 4posterior aspect, 1–2

with aerobic activity, 438

Bone grafts and grafting, for ankle fusions,532–533for midfoot crush injuries, 629, 633for tibial pilon fractures, with Tscherne

soft tissue injury, 461in metatarsal lengthening for brachyme-

tatarsia, one-stage, 559–564preferred procedure for, 568

of talus, for avascular necrosis, 771nonvascularized allograft,

763–765nonvascularized autograft,

761–763vascularized, 765–768

for stage 4 osteochondrallesions, 738

talectomy indications, 780–782with open reduction and internal

fixation, 704

Bone loss, with navicular arthrodesis, 75

Bone mineral density, with Charcotarthropathy, 597

Bone quality, distraction osteogenesisconsideration of, 512–513

Bone regrowth, distraction-stimlulated, bloodsupply and, 438–439, 442

histology of, 439–441

Bone scans. See Scintigraphy.

Bone scintigraphy. See also Nuclear medicineimaging (NMI).of Charcot arthropathy, preoperative

external fixation, 597of Muller-Weiss disease, 115, 122of navicular, accessory, 171–172,

186–188for osteochondral lesions, 201–202for stress fractures, 91–92,

99–100, 193–195

Bone strain, stress reaction and, 88

Bony cavus deformity, external fixationcorrection of, 612

anterior, 618posterior, 618, 620–623

treatment algorithm for, 611–612

Botulinum toxin A, use in lower extremity,339–348

clinical effects of, 340clinical indications for, 342–343for idiopathic toe walking,

343–346conclusions about, 346discussion on, 345–346methods of, 344–345results of, 345

future possibilities for, 346gait analysis, 340, 343, 345literature review, 339neuromuscular junction action

of, 340technique for, 340–342

Braces and bracing, for accessory navicular,173–174for navicular neuropathy, 155, 159for transverse tarsal joint control,

141–143lower extremity, after botulinum toxin

injection, 340–342, 344

Brachial plexus blockade, for complex regionalpain syndrome, 412

Brachymetatarsia, 555–571anatomy of, 557–558causes of, 556–557clinical presentation of, 558–559diagnostic critieria for, 557incidence of, 555, 557, 568pain with, 558, 567treatment of, 558–568

complications of, 566–567goals of, 558, 567–568


gradual lengthening procedure,564–566

one-stage lengthening procedure,558–564

patient selection importance, 568preferred procedures, 567–568syndactylization as, 558

Bridge plating, for midfoot injuries, 626–635complications of, 635goals of, 626indications for, 627, 636innovative strategies for, 646lateral, illustrative case, 629–632

surgical technique for, 629medial, illustrative case, 628

surgical technique for,627–628

postoperative management of,633–635

principles of, 626–627trauma presentations, 625–626

with barrel hoop plate, 633–635

Bridle procedure, for tendon transfers, forparalytic deformity, 331–332

Bupivacaine, interaction with regionalanesthesia, 357

Bupropian (Wellbutrin), for chronic painmanagement, 398

Bursa, metatarsal, anatomy of, 288inflammation of, 289

C

C fibers, in diabetic neuropathy, 224–225

Calandruccio clamp, for external fixation inankle fusions, 529–533

Calcaneal varus, with flatfoot, 138–139

Calcaneocuboid joint (CCJ), 127–145anatomy of, 130, 663–664biomechanics of, 130–134effects of fusion of, 680–681

combined with other joint fusions,679–681

orthotic control of, 139–144pathologic conditions of, 134–139

Calcaneus, in foot deformity measurement,492–500

mid-diaphyseal line, 492–493multiple tendon transfers to, for paralytic

deformity, 332–333osteotomy of, with navicular

arthrodesis, 81traction of, for tibial pilon fractures, 460

Callus and callotasis, bone, with distraction,439–440

in metatarsal lengthening,564–566

with fracture, 440–441

Canale view, in radiography, of talus,685–686, 694

for neck fracture, 725–726

Carbamazepine, for chronic painmanagement, 381

Carbon-fiber rods, for anterior ankle subluxa-tion control, 449–450, 452

Carpal tunnel compression, in diabeticpatients, 228

Casts and casting, for accessory navicular,173–174for malleolar fractures, 471for navicular neuropathy, acute, 153–155

chronic, 159–163for os trigonum, 789–790for tarsal navicular stress fractures,

95–97lower extremity, after botulinum toxin

injection, 340–342, 344

Causalgia, 405. See also Complex regionalpain syndrome (CRPS).

Cavovarus deformities, fixed, as naviculararthrodesis indication, 74

Cavus foot, external fixation correction of,611–624

arthrodesis and, 615causes of deformity, 611for bony cavus deformity, 612


for soft tissue cavus contractures,615–619gradual distraction technique

in, 612–615maintaining correction with,

613, 615obtaining correction with, 612–615orthotic management and, 613tendon transfer and, 613, 615treatment algorithm for,

611–612, 624types of deformity, 611

Celecoxib (Celebrex), for chronic painmanagement, 378–379

Cell transplantation, for stage 4 osteochondrallesions of talus, 738–741

discussion, 742–743results, 741–742


Center of rotation of angulation (CORA), indeformity analysis, 500–507

of hindfoot, 481of residual clubfoot in

adolescents, 572osteotomy rules based on, 501–504principles of, 500–501

Central nervous system (CNS), sensitizationof, with diabetic neuropathy, 225–226

Cerebral palsy, spastic, lower extremity botuli-num toxin injections for, 339, 342–343

Cervical radiofrequency neurolysis, forcomplex regional pain syndrome, 409

Cervical sympathetic block, for complexregional pain syndrome, 408–409

Charcot arthropathy, external fixation of,595–609

complications of, 601, 604contraindications to, 608fixator rings for, 599–600,

605–607foot frame technique, 596–597

pin spread for, 600, 606for ankle/foot deformity, 597–598,

602–604for midfoot correction, 599,

604–605for rocker bottom deformity,

599–600, 608fusion of esential joints and,

534–535, 599infection and, 597, 601, 604, 608nonweight bearing as critical to,

597, 600–601, 607–608preoperative management of,

595–597principles of, 598–601recurrence with, 608results of, 601techniques for, 597–601temporary application of, 599, 605tibiocalcaneal frame technique,

596–597, 605transfibular approach, 597–598,

602–604

Charcot-Marie-Tooth disease, cavus foot with,external frame fixation for, 509–510

soft tissue contracture management,612–615

tendon transfer for, 613, 615paralytic deformity with, tendon transfers

for, 327–328

Charnley fixator, for external fixation in anklefusions, 529, 533

Cheilectomy, for ankle osteoarthritis, prior tojoint distraction, 549–551

Chloroprococaine, interaction with regionalanesthesia, 356, 358

Chondrocytes, autologous transplantationof, for stage 4 osteochondral lesionsof talus, 738in ankle osteoarthritis, 542–543, 549

Chopart joints, dislocations of, 626–627bridge plating for, 626–635

lateral, 629–632medial, 627–628

ligament anatomy of, 11–14

Chronic pain, 373–403acute pain versus, 373classification types, 373–374definition of, 373epidemiology, 374–375neuropathic pain versus, 374nociceptive pain versus, 374organic pain versus, 374pharmacological management of,

375–400acetaminophen for, 375–376antiarrhythmics for, 399–400antidepressants for, 395–398antiepileptics for, 380–384centrally-acting agents for,

398–399COX-2 selective inhibitors for,

378–380goals of, 375local anesthetics for, 399–400multidisciplinary approach to, 375nonsteroidal anti-inflammatory

drugs for, 376–377opioids for, 384–395

psychogenic pain versus, 374

Circular frame, for external fixation, of tibialpilon fractures, 463, 465–466

complications of, 467–468

Claw toe deformity, flexor tenotomies for,509–510with motor neuropathy, 147–148

Clonidine, for complex regional painsyndrome, intrathecal, 411

intravenous, 412interaction with regional anesthesia,

358–359

Closed reduction, of subtalar dislocations,733–734of talar neck fractures, 723,

727–728, 730

Closing wedge osteotomy, rules for, based onfoot deformity analysis, 502–503

Clubfoot deformity, lower extremity botulinumtoxin injections for, 339, 342–343


residual in adolescents, Ilizarovcorrection of, 571–582

arthrogryposis and, 581description of frame,

576–577literature review of, 574–575osteotomy review, 575–576pathoanatomy of, 571–572postoperative managment of,

580–581preoperative radiographic

evaluation, 577–578soft tissue correction, 576surgical procedure

description, 578–580technique for, 572–573

talectomy for, 775, 777, 782–783

Cock-up toe deformity, withbrachymetatarsia, 558

Codeine, for chronic pain management,387–388

Comminuted fractures, of midfoot, bridgeplating for, 626, 628–629, 636

lateral, 629–632medial, 627–628with barrel hoop plate, 631,

633–634of tibial pilon, 459, 467

anterior ankle subluxation controland, 449

Common peroneal nerve, in modified three-point injection technique, for ankle block,369–370in surgical decompression, for diabetic

neuropathy, 245–246

Compartment syndrome, with malleolarfractures, 471with navicular fractures, 34–35

Compensatory deformities, of foot and ankle,493, 495–497

Complex regional pain syndrome (CRPS),405–417clinical features of, 405–406interventional modalities for, 406–414

epidural catheters, 412, 414intrathecal medications, 410–411peripheral nerve stimulation, 412radiofrequency neurolysis,

cervical, 409lumbar, 408

regional nerve blockade, 412spinal cord stimulation, 411–412sympathetic blocks, 406

cervical, 408–409lumbar, 407–408T2 and T3, 409–410

thoracic sympathetic chainblockade, 409–410

nomenclature evolution for, 405

Compression, for ankle fusions, 530,533–534, 536

Compression fractures, lateral navicular,imaging of, 190of talar head, 710of talar neck, 725

Computed tomography (CT) scan, for footdeformity measurement, 500for talus imaging, 686

in postoperative patient, 699–700of os trigonum, 789PET scans combined with, 687with fractures, 711, 714, 716–717,

719–720of talar neck, 726

with pathology, 689, 691–698, 741of midfoot crush injuries, 629–630, 633of Muller-Weiss disease, 115, 122of navicular, 182

bipartite variant, 184–186for acute trauma, 189–191for fractures, 32–33for osteochondral lesions, 199–202for osteonecrosis, 197for stress fracture, 88, 92–94,

193–194postoperative, 101–102

for tarsal coalition, 202–205of tibial pilon fractures, 456–459

Congenital deformities, of ankle,supramalleolar osteotomy for, 475–476shortening of first metatarsal.

See Brachymetatarsia.

Conservative treatment, of accessory navicular,173–174of anterior tarsal tunnel syndrome, 260of interdigital neuroma, 291of stress fractures, of tarsal navicular,

95–96of superficial peroneal nerve

entrapment, 263of sural nerve entrapment, 266versus talonavicular-cuneiform

arthrodesis, for Muller-Weissdisease, 65

Consolidation period, post-Ilizarov externalfixation, 436

Containment procedures, with nervetransection, for chronic intractable lowerextremity pain, 308–310

Contractures. See specific anatomy.


Core decompression, of talus, for avascularnecrosis, 758, 760

results of, 760–761

Corticosteroid-induced osteonecrosis, oftalus, 749

Corticosteroid injections, for interdigitalneuroma, 291for tarsal tunnel syndrome, 279–280

anterior, 260

Corticotomy, for Ilizarov external fixation,436–437

Cosmesis, in brachymetatarsia treatment, 558

COX-2 enzymes, in chronic pain management,acetaminophen actions on, 375–376

NSAID actions on, 376–377selective inhibitors of, 378–380

COX-2 selective inhibitors, for chronic painmanagement, 378–380

cardiovascular system and, 380gastrointestinal complications with,

378–379hypertension with, 379–380mechanisms of, 378renal complications with, 379

Crush injuries, external fixation for, 535in acute ankle trauma, 591–592

of midfoot, bridge plating for, 626–635.See also Bridge plating.

barrel hoop plate with,631, 633–635


consequences of, 625–626treatment goals for, 626

of talus, 710–711, 720

Cuboid fractures, bridge plating for, 626,629–630, 633, 635

D

‘‘Dead bone sandwich,’’ with navicularfractures, 25

Debridement, arthroscopic, for stage 4osteochondral lesions of talus, 737–738

of ankle osteoarthritis, 541, 545,549–550

Deep peroneal nerve, anatomy of, 256–257variations in, 257

in surgical decompression, fordiabetic neuropathy, 246–247

Deformity(ies). See also specific deformity.analysis of measurement of, 500–507anterior ankle subluxation as, dynamic

control strategies for, 449–453

bony cavus, anterior versus posterior,618, 620–623treatment algorithm for, 611–612

cavus. See Cavus foot.claw toe, with motor neuropathy,

147–148clawtoe, flexor tenotomies for, 509–510clubfoot. See Clubfoot deformity.cock-up toe, with brachymetatarsia, 558compensatory, 493, 495–497congenital deformities, of ankle,

supramalleolar osteotomy for,475–476shortening of first metatarsal.

See Brachymetatarsia.equinovarus, talectomy for, 777–778,

782–783equinus, lower extremity botulinum toxin

injections for, 339, 342external fixation frame design for,

509–510fixed cavovarus, as navicular arthrodesis

indication, 74flatfoot. See Flatfoot deformity.floppy forefoot, for navicular neuropathy,

159–161hindfoot. See Hindfoot deformity(ies).measurement for evaluation of, 492–500midfoot. See Midfoot deformity(ies).of ankle and foot.

See Ankle/foot deformity.paralytic, 319–337. See also

Paralytic deformity.pes planus. See Pes planus deformity.pes plenovalgus, as navicular arthrodesis

indication, 74procurvatum, 497, 511rocker-bottom. See Rocker-

bottom deformity.severe, innovative fixation strategies for,

642, 644–645supramalleolar osteotomy for, 475–487

arthritis and, 476–477complications of, 486congenital deformities, 475–476developmental deformities,


talectomy for, 775, 777–779valgus. See Valgus deformity(ies).varus. See Varus deformity(ies).with Charcot arthropathy, external

fixation of, 597–598, 602–604

Degenerative joint disease, metatarsophalan-geal, as interdigital neuroma cause,289–290


of ankle. See Ankle osteoarthritis (AO).

Demyelination, of segmental nerve, inentrapment, 255–256

Dental pathology, with Muller-Weissdisease, 115

Developmental deformities, of ankle,supramalleolar osteotomy for, 475–476

Dexmetotomidine, interaction with regionalanesthesia, 355

Diabetic neuropathy, 221–237. See alsoTarsal navicular.acute versus chronic, 227–228alteration in pain gate, 224–225arthropathy with, talectomy for, 780–781biomechanical factors of, 241–242blood flow and, 227, 229–230, 240causes of, 239–240central spinal sensitization and, 225–226definition of, 1, 223double crush hypothesis of, 242ectopic electrical impulses and, 226increased complication risks with,

221, 223metabolic factors of, 227, 240–241

reduced nerve perfusion and,230–233

nerve hypersensitivity with, 223–224pathogenesis of, 223–224, 229–233

advanced glycation endproducts, 231

aldose reductase pathway, 230–231impaired fatty acid metabolism, 232metabolic theories, 229–230polyol pathway, 230–231protein kinase C theory, 232reactive oxygen intermediate

theory, 231–232theories under investigation,

232–233risk factors for, 228–229spinal rewiring with, 225surgical decompression for, 239–254

animal studies on, 242–243authors’ experience, 245chart review, 250–251common peroneal nerve in,

245–246deep peroneal nerve in, 246–247discussion, 239, 252etiology considerations with,

239–242human results, 243–244indications for, 249neurosensory testing in, postopera-

tive, 251–252preoperative, 248–249, 251

operative technique, 245

postoperative care for, 248results review, 249–250tarsal tunnel in, 247–248

types of, 221–223vascular factors of, 227, 229–230, 240

Digital arteries, anatomy of, 288

Digital nerves, plantar, anatomy of, 287–288

Digital veins, anatomy of, 288

Disability, pain-related, 375

Diseases, involving talus, osteonecrosisfollowing, 745–746, 749

Dislocations, of Lisfranc’s joints, 627bridge plating for, 627–628, 630

of midtarsal joints, 626–627bridge plating for, 626–635


of talar head, with shear fractures,710–711

subtalar, 733–734unstable reduction of, as external fixation

indication, 587–591with navicular fractures, 34–35

treatment of, 43–50with navicular neuropathy, complete

transverse tarsal joint, 159–160medial, 155–159

Displacement, of talus fractures, 710–711,717, 719with tibial pilon fractures, 459, 467

Distal articular set angle (DASA), inMuller-Weiss disease, 120

Distal axes, in deformity analysis, 500–507

Distal fibular osteotomy, in talus surgery, 705

Distal symmetrical sensorimotor polyneurop-athy (DSSP), pathogenesis of, 222, 230,232–233surgical decompression for, 240

Distal tarsal tunnel, anatomy of, 273

Distal tibia, innovative external frame designsfor, 640–642

Distraction, gradual, for soft tissue cavuscontractures, 612–615

innovative external frame designsfor, 642–643

of joints, for ankle osteoarthritis,541–553. See also Ankleosteoarthritis; Joint distraction.

Distraction arthroplasty, of ankle joint,biomechanics of, 442–443

Distraction callotasis, 439–440


in metatarsal lengthening forbrachymetatarsia, 564–566

Distraction osteogenesis, biomechanics of,437–439external fixation for, 489–528

case report 1, 513–518case report 2, 518–521case report 3, 521–525case report 4, 523–524, 526–527deformity analysis, 500–507deformity measurement, 492–500deformity types, 495, 497evolution of, 489–490frame design, 509–510goal of, 490indications for, 489–490, 528osteotomy techniques, 492,

506–509other considerations, 512–513patient selection for, 490–491rule of similar triangles for,

511–512soft tissue contractures, 510–511structures at risk, 511–512surgical indications for, 490–491surgical planning for, 491–492

histology of, 439–441innovative strategies for, 640

Distraction period, post-Ilizarov externalfixation, 436

Dopamine reuptake antidepressants, forchronic pain management, 397–398

Dopamine reuptake inhibitors, for chronic painmanagement, 398

Dorsolateral peritalar subluxation, rigid, asnavicular arthrodesis indication, 74

Double crush hypothesis, of diabeticneuropathy, 233, 242

Double crush phenomenon, peripheralneuralgia from, 306–307

‘‘Double navicular,’’ with Muller-Weissdisease, 66, 69

Drug therapy(ies).See Pharmacological management.

Dysrhythmias, with local and regionalanesthesia mixtures, 356

Dystonias, focal, lower extremity botulinumtoxin injections for, 339, 342

E

Ectopic electrical impulses, with diabeticneuropathy, 226

Ectopic neuralgia, nerve transection withcontainment for, 309–310

Eichenholtz classification, of navicularneuropathy, 149

Electrodiagnostic testing, for chronicintractable lower extremity neuropathicpain, 306–307for superficial peroneal nerve

entrapment, 263for tarsal tunnel syndrome, 278

anterior, 260

Electromyogram (EMG), for anterior tarsaltunnel syndrome, 260needle guidance, for lower extremity

botulinum toxin injection, 340–341

Endoneurial hypoxia, in diabetic neuropathy,229–230

Endoscopic decompression, of intermetatarsalnerve, for Morton’s neuroma, 297–304

advantages of, 303–304anatomy for, 298, 300–301history of, 297pathogenesis of, 297rationale for treatment,

297–298surgical technique, 301–303

endoscopic view oftransverseligament,300–301, 303

instrumentation for,299, 301

intraoperative views of,299–302

uniportal decompressionof, 298, 303

Entrapment neuropathy, in tarsal tunnelsyndrome, 275–276interdigital neuromas as, 287, 290, 294

Enucleations, as external fixation indication,with acute ankle trauma, 588–591

Epidural catheters, for complex regional painsyndrome, 412, 414

Epiphyseal arrest, metatarsal, brachymetatarsiafrom, 555, 557

Equinovarus deformity, talectomy for,777–778, 782–783

Equinus contracture, external fixation for,510–511, 536

with ankle osteoarthritis, 546,548–550

with cavus foot, 617–618

Equinus deformity, lower extremity botulinumtoxin injections for, 339, 342


Evan’s procedure, for accessory navicular,176–177

Eversion mechanics, as foot deformitycompensation, 493, 495–497in peritalar joint, 664of subtalar joint, 130–134

Excision, of accessory navicular, 179

Exostectomy, for anterior tarsal tunnelsyndrome, 260–261

Extensor digitorum longus muscle, in anteriortarsal tunnel syndrome, 257–259

Extensor hallucis longus muscle, in anteriortarsal tunnel syndrome, 257–259, 261

External fixation, biomechanics of, 433–448ankle joint distraction arthroplasty

and, 442–443distracted bone histology and,

437–441fixator characteristics, 433–436Ilizarov technique, 434, 436–437limb lengthening forces, 437soft tissue response to distracted

bone, 441–442for acute ankle trauma, 455–474,

583–594anatomic particularities, 583for malleolar fractures, 470–471for tibial pilon fractures, 455–470

complications of, 467–469evaluation of, 456–459evolution of, 455–456goals of, 459–460results of, 469–470techniques for, 459–467


functional particularities, 583indications for, 638

osteoarticular structure lossas, 584–587

soft tissue reconstruction byflaps as, 591–593

soft tissues jeopardized as,584–587

unstable reduction of disloca-tions as, 587–591

innovative strategies for, 646limitations of, 639traumatic consequences and,

583–584, 592–593treatment goals of, 584, 589, 592

for anterior ankle subluxation control,449–453Anderson’s technique for, 449, 451indications for, 449

recent innovative technique for,449–450, 453

for cavus foot, 611–624arthrodesis and, 615causes of deformity, 611for bony cavus deformity, 612


for soft tissue cavus contractures,615–619gradual distraction technique

in, 612–615maintaining correction with,

613, 615obtaining correction with, 612–615orthotic managment and, 613tendon transfer and, 613, 615treatment algorithm for,

611–612, 624types of deformity, 611

for Charcot arthropathy, 595–609complications of, 601, 604contraindications to, 608fixator rings for, 599–600,

605–607foot frame technique, 596–597

pin spread for, 600, 606for ankle/foot deformity, 597–598,

602–604for midfoot correction, 599,

604–605for rocker bottom deformity,

599–600, 608fusion of esential joints and, 599infection and, 597, 601, 604, 608nonweight bearing as critical to,

597, 600–601, 607–608preoperative management of,

595–597principles of, 598–601recurrence with, 608results of, 601techniques for, 597–601temporary application of, 599, 605tibiocalcaneal frame technique,

596–597, 605transfibular approach, 597–598,

602–604for distraction osteogenesis, 489–528

case report 1, 513–518case report 2, 518–521case report 3, 521–525case report 4, 523–524, 526–527deformity analysis, 500–507deformity measurement, 492–500deformity types, 495, 497evolution of, 489–490frame design, 509–510goal of, 490indications for, 489–490, 528


osteotomy techniques, 492,506–509

other considerations, 512–513patient selection for, 490–491soft tissue contractures, 510–511structures at risk, 511–512surgical indications for, 490–491surgical planning for, 491–492

for foot and ankle fusions, 529–539Charcot arthropathy and,

534–535, 599chronic osteomyelitis and, 533fixator devices for, 530–533literature review of, 529midfoot stabilization with,

533–537osteomyelitis as indication, 536osteoporosis as indication,

532–533pin placement, 530postoperative care, 531revision procedures, 533tibiotalar joint exposure, 529–530tibiotalar joint positioning, 530

for joint distraction of ankle osteoarthri-tis, pearls and pitfalls of, 549–552principles of, 543–545techniques for, 545–549

for navicular neuropathy, 162–163for residual clubfoot deformity in

adolescents, 571–582arthrogryposis and, 581correction technique, 572–573description of frame, 576–577literature review of, 574–575osteotomy review, 575–576pathoanatomy of, 571–572postoperative managment of,


evaluation, 577–578soft tissue correction, 576surgical procedure description,

578–580historical acceptance of, 637in metatarsal lengthening for

brachymetatarsia, 564–566complications with, 567preferred procedure for, 567–568

infection as indication for, 585, 637–638innovations and future directions in,

637–647clinical applications of, 640–646contemporary uses versus,

637–639for anterior ankle subluxation

control, 449–450, 453historical uses versus, 637

internal fixation with, 456, 640of navicular fractures, 36–39, 56

plates as alternative to, 625–636advantages of, 625, 635–636barrel hoop plating, illustrative

case, 633–635surgical technique for,

631, 633bridge plating, 626–635

complications of, 635indications for, 627, 636lateral, illustrative case,

629–632surgical technique for, 629

medial, illustrative case, 628surgical technique for,

627–628postoperative management of,

633–635principles of, 626–627with barrel hoop plate,

633–635for midfoot injuries, 625–626

unique attributes of, 637–638

F

Fascia, biomechanical response to distractedbone, 441–442

Fasciectomy, lateral compartment, for superfi-cial peroneal nerve entrapment, 264Tachdjian plantar, for soft tissue cavus

contractures, 612–615

‘‘Fast-tracking’’ patients, to minimizepostanesthesia care unit resources,350, 354

Fatigue fractures. See Stress fractures.

Fatty acid metabolism, impaired, in diabeticneuropathy, 232

Felbamate, for chronic pain management, 384

Femoral nerve, anatomy of, 359

Femur, in foot deformity measurement,498–500

Fentanyl, for chronic pain management,388–389

Fibular tunnel, in diabetic neuropathy, surgicaldecompression of, 245

First metatarsal, congenital shortening of.See Brachymetatarsia.

Fixation techniques. See alsospecific technique.for talus, 703–704

with arthrodesis, 770–771with fractures, crush, 721

lateral process, 717–718


of neck, 723posteriormedial, 720talar body, 714–716talar head, 712–713

with talectomy, 780–781,783–784

traditional versus new, for tendontransfers, 335–336

Fixators and fixator rings, external,biomechanics of, 433–436

disadvantages of, 433for ankle fusions, 530–533for Charcot arthropathy, 599–600,

605–607indications for. See External fixation.

Flap reconstruction, as external fixation indi-cation, for acute ankle trauma, 591–593distraction osteogenesis consideration

of, 512

Flatfoot deformity, adult, posterior tibialtendon dysfunction in, 674compensatory mechnisms with, 137–138effect on kinematics, of talocalcaneal

joint, 672–674of talonavicular joint, 674–676

effect on kinetics, of talonavicular joint,677–678

orthotic control of, 141–144pathology of, 135–137secondary changes with, 138–139

Flexion, as os trigonum mechanism, 788, 790in peritalar joint biomechanics, 664

Flexor hallucis longus (FHL) tendon, in ostrigonum, 787, 790–794

Flexor retinaculum, in tarsal tunnel syndrome,272–273

surgical release of, 280–281

Flexor tenotomies, for clawtoe deformity,509–510

Floppy forefoot deformity, for navicularneuropathy, 159–161

Focal dystonias, lower extremity botulinumtoxin injections for, 339, 342

Foot frame, for external fixation, of Charcotarthropathy, 596–597

pin spread for, 600, 606

Foot plates, as model of transverse tarsal joint,130–133for joint distraction, of ankle

osteoarthritis, 546–548

Foot rings, for joint distraction, of ankleosteoarthritis, 546–547

Force couple, in tendon transfers, for paralyticdeformity, 321–322

Forefoot, alterations in Muller-Weiss disease,120–121

Fracture(s), comminuted, bridge plating formidfoot, 626, 628–629, 636

lateral, 629–632medial, 627–628with barrel hoop plate, 631,

633–634cuboid, bridge plating for, 626malleolar, external fixation for, 470–471navicular, 25–63

anatomy of, 26–27avulsions, 28

treatment of, 41–43classification of, 27–32clinical presentations of, 25, 33–35displaced, with neuropathy,

157–158functional impact of, 25imaging of, 32–33, 188–190nonreconstructible, 35, 56–57of accessory bone, 31–32

treatment of, 50–51of body, 28–30of tuberosity, 31–32

treatment of, 50–51operative treatment of, 35–62

complications with, 60–62dislocations, 51–53external fixation as,

36–39, 56gastrocnemius recession and,

53–54internal fixation as, 29, 35,

43–50K wires for, 38–42, 45–46,

50, 52, 56nonreconstructible challenges,

35, 56–57of accessory fractures, 50–51of avulsions, 41–43of body fractures, 43–50of tuberosity, 50–51patient positioning in, 39, 41postoperative care in, 55–56primary arthrodesis as, 57–60timing of, 36

rehabilitation of, 55–56soft tissue trauma with, 34–35,

56–57treatment of, keys to successful,

26, 35, 62nonoperative, 35operative, 35–62

talar neck, 723–736anatomy and, 724–725blood supply and, 724–725complications of, 726, 734–735diagnosis of, 725–726


history of, 723–724mechanism of, 725open, 733osteonecrosis following, 745–746postoperative treatment of,

731–732staging of, 726–727subtalar dislocations, 733–734treatment of, 726–731

talectomy for, 778–780talus, 709–722

crush, 710–711, 720imaging of, 694–696lateral process, 716–718outcomes, 711pathoanatomy in, 709posterior process, 788posteriormedial, 718–720talar body, 714–716talar head, 709–713talar neck, 723–736treatment algorithm for, 723–724

tarsal navicular, bridge plating for, 626,631, 633–634

tarsal tunnel syndrome from, 274, 281tibial, innovative fixation strategies for

nonunion of, 642–643tibial pilon, external fixation for,

455–470anterior ankle subluxation control

and, 449complications of, 467–469evaluation of, 456–459evolution of, 455–456goals of, 459–460results of, 469–470techniques for, 459–467


Frame designs, external. See alsospecific design.

for Charcot arthropathy, 596–597,600, 606

for deformity correction, 509–510for distal tibia, 640–642for joint distraction of ankle

osteoarthritis, principles of,543–545surgica techniques based on,

545–549for soft tissue cavus contractures,

615–617for tibial pilon fractures, 460, 463,

465–468Ilizarov technique. See Ilizarov

frame/technique.of tibial pilon fractures,

463–464, 466

rule of similar triangles for,511–512

Taylor spatial. See Taylorspatial frame.

wire. See Wire frame fixation.

Free radicals, in diabetic neuropathy, 231–232

Frontal plane mechanics, in foot deformitymeasurement, 499–500in peritalar joint, 664

Fulcrum fixation, external, for soft tissue cavuscontractures, 616–618

Fusion(s). See Arthrodeses.

G

Gabapentin, for chronic pain management,381–382

Gait analysis, in animal studies, on diabeticneuropathy, 242with lower extremity botulinum toxin

injections, 340, 343, 345

Gait cycle, transverse tarsal joint mechanics in,130–134

Gastrocnemius muscle, botulinum toxin injec-tion in, for toe walking, 341–346contractures of, in joint distraction, for

ankle osteoarthritis, 546, 549–550recession of, role in navicular fractures,

53–54

‘‘Gate mechanism of pain,’’ 280

General anesthesia, for lower extremity,regional anesthesia versus, 350

Gigli saw, for cavus foot correction, 618in distraction osteogenesis, 506–509

Glycation end products, advanced, in diabeticneuropathy, 231

Glycemic control, as diabetic neuropathyfactor, 227–230

metabolic theories of, 230–233

Gradual distraction, for soft tissue cavuscontractures, 612–615innovative external frame designs for,

642–643

Grafts and grafting. See also specific type.for accessory navicular, 176–177for navicular arthrodesis, 75, 81

in Muller-Weiss disease, 68, 70for stage 4 osteochondral lesions of

talus, 738for tarsal navicular stress fractures,

97–98


Guanethedine, intravenous, for complexregional pain syndrome, 412

H

Hallux valgus, with Muller-Weiss disease,115, 120

Harris Beath view, in radiography, of talus,685–686, 689–690

Hawkin’s classification, of talar neck fractures,726–727

Hawkin’s sign, in talus evaluation, for avascu-lar necrosis, 757–759

for fractures, 695–696of neck, 731

for osteonecrosis, 750–751

‘‘Heel pain triad,’’ tarsal tunnel syndromefrom, 275

Heel wedge, for transverse tarsal joint control,139–141

Hemoglobin A1c, as diabetic neuropathyfactor, 229

Hindfoot, axes of rotation, 664

Hindfoot alignment radiograph, for deformityevaluation, 495, 498

preoperative supramalleolarosteotomy, 483

Hindfoot deformity(ies), external fixationframe designs for, 489–490, 509–510in Muller-Weiss disease, 116–117supramalleolar osteotomy for, 475–487

arthritis and, 476–477complications of, 486congenital deformities and,

475–476developmental deformities and,


Hinged fixation, angulation correction axis assite for, 501, 504external, for soft tissue cavus

contractures, 616–618

Hip, in foot deformity measurement, 498–500

Hoffman fixator, for external fixation, 434in ankle fusions, 529, 531, 533

Hybrid external fixation, biomechanicaldesigns for, 434, 531for tibial pilon fractures, 462–467

complications of, 467–469results of, 469–470

Hydromorphone, for chronic painmanagement, 387

Hydroxyapatite-coated pins, biocompatibilityof, 639–640

Hyperglycemia, as diabetic neuropathy factor,227–230

metabolic theories of, 230–233

Hypoplastic metatarsal. See Brachymetatarsia.

Hypoxia, endoneurial, in diabetic neuropathy,229–230

I

Idiopathic osteonecrosis, of talus, 749

Idiopathic toe walking, botulinum toxin for,343–346

conclusions about, 346discussion on, 345–346methods of, 344–345results of, 345

Ilizarov frame/technique, of external fixation,biomechanical design of, 434–436

bone distraction rate and, 438for Charcot arthropathy,

533–534, 536for clubfoot deformity in

adolescents, 571–582arthrogryposis and, 581correction technique,

572–573description of frame,

576–577literature review of, 574–575osteotomy review, 575–576pathoanatomy of, 571–572postoperative managment of,


evaluation, 577–578soft tissue correction, 576surgical procedure

description, 578–580for distraction osteogenesis,

489–490, 509–510for tibial pilon fractures, 456, 463

complications of, 467–468innovative external frame designs

versus, 642leg lengthening procedures for,

436–437rule of similar triangles for,

511–512soft tissue contracture correction

for, 436–437


Imaging. See also specific test.of accessory navicular, 171–173of Muller-Weiss disease, 66–67,

196–198of navicular, anatomy, 2–20

fractures, 32–33, 36stress, 88–91, 191–194

of talus, 685–701CT scans, 686for avascular necrosis treatments.

See Avascular necrosis (AVN).for osteonecrosis, 750–753MRI, 687–688normal variations with associated

pathology, 688–699arthritis, 693avascular necrosis, 693–694fracture, 694–696os trigonum, 688–689, 789osteochondral lesions,

691–693osteomyelitis, 698–699talar beak, 689–691tarsal coalition, 689–691tumor, 696–698

nuclear medicine-positron emissiontomography, 686–687

postoperative patient evaluation,699–700

radiography, 685–686weight-bearing for talonavicular

joint, 686, 689

Immobilization. See also specific technique.for os trigonum, 789–790for stage 4 osteochondral lesions of

talus, 737for talus fractures, 712–713,

717–718, 720of talar neck, 731–733, 735

for tarsal tunnel syndrome, 279–280

Immunologic factors, of diabeticneuropathy, 233

Indoleacetic acid derivates, for chronic painmanagement, 377

Infection, with talar neck fractures, 734–735

Infection(s), as external fixation indication,637–638

for acute ankle trauma, 585,637–638

pin track, with external fixation, 531,552, 626

innovative prevention of,639–640

of tibial pilon fractures,463, 468

with Charcot arthropathy, externalfixation and, 597, 601, 604, 608

with joint distraction, of ankleosteoarthritis, 552

Inferior calcaneonavicular ligament (ICN),anatomy of, 9–11in transverse tarsal joint, 129–130, 137

Inflammation, synovial, in ankle osteoarthritis,542–543

Inguinal lumbar plexus nerve block, 3:1, forlower extremity, 361–362

Innovative external fixation, 637–647clinical applications of, 640–646contemporary uses versus, 637–639for anterior ankle subluxation control,

449–450, 453historical uses versus, 637

Insitu dowel grafting arthrodesis, of talus, foravascular necrosis, 770

Insulin-like growth factors (IGFs), in diabeticneuropathy, 233

Interdigital neuritis, 287

Interdigital neuromas, surgical state of the art,287–296

anatomy of, 287–288as entrapment neuropathy, 287,

290, 294causes of, 288–290diagnosis of, 290–291epidemiology of, 288–290treatment of, 291–294

Intermetatarsal nerve, endoscopic decompres-sion of, for Morton’s neuroma, 297–304

advantages of, 303–304anatomy for, 298, 300–301history of, 297pathogenesis of, 297rationale for treatment,

297–298surgical technique, 301–303

endoscopic view oftransverse ligament,300–301, 303

instrumentation for,299, 301

intraoperative views of,299–302

uniportal decompressionof, 298, 303

Intermittent fluid pressure, in ankle osteoarthri-tis, 217^11, 542–543

Internal fixation, external fixation with,456, 640in metatarsal lengthening for

brachymetatarsia, 560–564joint-bridging fixation, for acute ankle

trauma, 592–593for malleolar fractures, 471


of navicular fractures, 35for Muller-Weiss disease, 66tuberosity and accessory, 50–51with body dislocations, 29, 43–50

type 1, 44–45type 2, 45–48type 3, 48–49

of talus, 703–704with neck fractures, 723, 726–728

open reduction with. See Open reductionand internal fixation.

Internal oblique radiography view, ofnavicular, 182–184

Interposition grafts, in metatarsal lengtheningfor brachymetatarsia, 559, 562–564, 568

Intramedullary fixation, for talectomy, 783

Intrathecal medications, for complex regionalpain syndrome, 410–411

Inversion mechanics, as foot deformitycompensation, 493, 495–497in peritalar joint, 664of subtalar joint, 130–134

orthotic control of, 139–143

Ischemia, of nerves, as interdigital neuromacause, 288–289

in diabetic neuropathy, 229–230, 233

Ischemic contractures, innovative fixationstrategies for, 642, 644–645

J

Joint(s). See also specific joint.arthrosis of adjacent, with navicular

arthrodesis, 82normal angles of, 499–500of navicular and periarticular structures,

2, 4–6

Joint-bridging fixation, internal, for acute ankletrauma, 592–593

for malleolar fractures, 471

Joint disease, degenerative, 541–542. See alsoAnkle osteoarthritis (AO).

Joint distraction, for ankle osteoarthritis,541–553

alternative treatments versus,541, 552

biomechanics and biology of,442–443

clinical results of, 543–545complications of, 552functional outcomes of, 544–545,

551–552indications for, 545, 639innovative strategies for, 643,

645–646

pathophysiology of, 541–542pearls and pitfalls of, 549–552postoperative care for, 549scientific rationale for, 541–543serial radiographs of, 548–550surgical technique for, 545–549weight bearing with, 541,

543–545, 550–551

Joint fusion. See Arthrodeses.

Joint surfaces. See Articular surfaces.

K

K-wire fixation, for Charcot arthropathy, 598,602–604for foot and ankle fusions, 530, 534–536in bridge plating, for midfoot crush

injuries, 627, 629, 633for tibial pilon fractures, with

Tscherne grade II soft tissueinjury, 457–462, 469

of navicular fractures, 38–42, 45–46,50, 52, 56stress, 98

Kidner procedure, for accessory navicular,174–175, 178–179

modification of, 176

Kinematics, of talocalcaneal joint, 664–667alignment effect on, 672–674articular surfaces shapes, 664–665axis of rotation, 665–666screwlike motion, 667x-ray stereography of motion,

666–667of talonavicular joint, 667–670

alignment effect on, 674–676articular surfaces shapes, 667–668axis of rotation, 668–670x-ray stereography of motion,

669–670

Kinetics, of talocalcaneal joint, 670–671alignment effect on, 676–677

of talonavicular joint, 671–672alignment effect on, 677–678loading and, 671, 674–675

Knee joint, in foot deformity measurement,compensation mechanisms, 493, 497

normal angles of, 499–500

Kohler’s disease, of navicular, 105imaging of, 196–197

L

Lamina pedis model, of transverse tarsal joint,130–133


Lamina spreader, for external fixation, in anklefusions, 530

of Charcot arthropathy, 599, 605

Lamotrigine, for chronic pain management,382–383

Latency period, post-Ilizarov externalfixation, 436

Lateral approach, to talus surgery, 707–708

Lateral bridge plating, for midfoot injuries,illustrative case, 629–632

surgical technique for, 629

Lateral calcaneonavicular ligament, anatomyof, 5, 12

Lateral column injury, of talar head, 711

Lateral column lengthening, effect onkinematics, of talonavicular joint,674–675

Lateral compartment fasciectomy, for superfi-cial peroneal nerve entrapment, 264

Lateral oblique radiography view, of navicular,182–184

Lateral open arthrodesis, of talus, for avascularnecrosis, 770

Lateral process fractures, of talus, 716–718pathology of, 716treatment of, 717–718

Lateral radiograph, of anterior anklesubluxation control, 450–451, 453

Leg ring, for joint distraction, of ankleosteoarthritis, 546–547

Length(s), extension of. See Limb lengthening.in deformity measurement, 492–500.

See also Limb-length discrepancy.

Lesser metatarsophalangeal joint, degenerativedisease of, as interdigital neuroma cause,289–290

Letournel reconstruction plate, for midfootcrush injuries, 630, 632

Levorphanol, for chronic painmanagement, 390

Lidocaine, interaction with regionalanesthesia, 358

Ligaments, in soft tissue contractures,509–510joint laxity of, in deformity

measurement, 493metatarsal, anatomy of, 288of navicular and periarticular structures,

4–14

bifurcate (Chopart’s), 11–14inferior calcaneomavicular, 10–11superomedial calcaneomavicular,

6–10support function, 4–6tarsal, 86

of transverse tarsal joint, 128–130in flatfoot deformity, 135–137

Limb-length discrepancy, in foot deformity,innovative external frame designsfor, 642

measurement of, 498–500

Limb lengthening, for Ilizarov externalfixation, 436–437

bone distraction rate and, 437–441forces require for, 437

Lisfranc’s joints, dislocations of, 627bridge plating for, 627–628, 630

external fixation of injuries of, 535–536

Loading, ankle joint fusion effects on,678–681in talus fractures, 710, 714, 716, 721kinetics of, in talocalcaneal joint,

670–671, 676–677in talonavicular joint, 671–672,

674–675

Local anesthetics (LAs), for anterior tarsaltunnel syndrome, 260, 263for chronic pain management, 399–400for lower extremity regional anesthesia,

355–357to mix or not to mix

controversy, 357

Long axial radiograph, for deformityevaluation, 495, 499

Lower extremity, anatomy of, 359–360botulinum toxin use in, 339–348

clinical effects of, 340clinical indications for, 342–343for idiopathic toe walking,

343–346conclusions about, 346discussion on, 345–346methods of, 344–345results of, 345

future possibilities for, 346gait analysis, 340, 343, 345literature review, 339neuromuscular junction action

of, 340technique for, 340–342

malalignment of, supramalleolarosteotomy for, 478

neuropathy in. See Diabetic neuropathy.regional anesthesia for, 349–372


avoiding postoperative nausea andvomiting, 350, 352–353

critical questions for, 349–350duration increase, 358–359‘‘fast-tracking’’ patients to

minimize postanesthesia careunit resources, 350, 354

guidelines for, 367local anesthetics and, 355–357

to mix or not to mixcontroversy, 357

minimizing controlled time andmaximizing operative time,349, 351–352

moving to operating room aftersuccessful placement,351–352

onset time decrease, 357–358patient safety with, 354performing in special preoperative

area with trained nursing staff,350–351

peripheral nerve blocks and,359–3663:1 inguinal lumbar plexus

technique, 361–362anatomy considerations,

359–360ankle techniques, 366guidelines, 367lumbar plexus techniques,

360–362of psoas compartment lumbar

plexus, 360–362patient management

following, 367–368proximal to distal list of, 352saphenous techniques,

365–366sciatic techniques, 362–365

anterior, 363distal, 364lateral, 364–365posterior, 363–364proximal, 363single versus double, 365

setup time for, 358Winnie technique, 361–362

sedation with, 354–355using for postoperative analgesia,

350, 352–353using in preference to general

anesthesia, 350

Lumbar plexus, anatomy of, 359–360

Lumbar plexus nerve blocks (LPNB), forcomplex regional pain syndrome, 412psoas compartment, for lower extremity,

360–362

Lumbar radiofrequency neurolysis, forcomplex regional pain syndrome, 408

Lumbar sympathetic block, for complexregional pain syndrome, 407–408

Lumbrical tendons, anatomy of, 288

M

M-T (Meary-Tomeno’s) angle, in Muller-Weissdisease, 121–122

Magnetic resonance imaging (MRI), ofinterdigital neuroma, 291of Muller-Weiss disease, 115, 122of navicular, 182, 188

accessory, 172–173for osteochondral lesions, 200–202for osteonecrosis, 197for stress fractures, 88, 91–92, 94,

193–195for tarsal coalition, 204–205

of sural nerve entrapment, 266of talus, 687–688

in postoperative patient, 699–700of os trigonum, 789of osteonecrosis, 749, 752–753with pathology, 689, 691–699

of tarsal tunnel syndrome, 279anterior, 263

Malalignment, of lower extremity,supramalleolar osteotomy for, 478with navicular arthrodesis, 81–82

in Muller-Weiss disease, 68

Malicky procedure, for accessorynavicular, 176

Malleoli, fractures of, external fixation for,470–471in foot deformity measurement,

493–494, 500

Malunion, of talar neck fractures, 726,734–735

Manter method, of axis of rotation determina-tion, in talocalcaneal joint, 665–666

Matrix mineralization, in imaging of talus,696–697

MBA implant, for accessory navicular,176–177

Meary-Tomeno’s (M-T) angle, in Muller-Weissdisease, 121–122

Medial approach, to talus surgery, 708

Medial bridge plating, for midfoot injuries,illustrative case, 628

surgical technique for, 627–628


Medial calcaneal opening wedge osteotomy,for ankle deformity and arthritis,485–486in Iizarov technique, for clubfoot

deformity correction, 575

Medial calcaneonavicular ligament, anatomyof, 12, 14

Medial column reconstruction, for navicularneuropathy, 157–159

Medial dislocation, with navicular neuropathy,acute treatment of, 155–159

Medial fixators, innovative strategies for, 643,645–646

Medial malleolar osteotomy, in talus surgery,704–706

Meperidine, for chronic pain management, 390

Mepivacaine, interaction with regionalanesthesia, 356–358

Metabolic factors, of diabetic neuropathy, 227,240–241


Metatarsal(s), hypoplastic.See Brachymetatarsia.inflammation of, 289neuroanatomy of, 288

Metatarsal adductus, in Muller-Weiss disease,111–112, 120–121in tarsal navicular stress fractures, 87–88

Metatarsal lengthening, for brachymetatarsia,gradual, 564–566

one-stage, 558–564

Metatarsal pads, for interdigital neuroma, 291

Metatarsal shortening, forbrachymetatarsia, 564

Metatarsalgia, Morton’s, 287

Methadone, for chronic pain management, 389

Microfracture, for stage 4 osteochondrallesions of talus, 738

Microtrauma, as interdigital neuromacause, 289

Microvascular disease, in diabetic neuropathy,230–231

Mid-diaphyseal line, of tibia, in foot deformitymeasurement, 492–494

Midfoot, alterations in Muller-Weiss disease,117–120biomechanics of, 130–134

crush injuries of, bridge plating for,626–635. See also Bridge plating.

barrel hoop plate with, 631,633–635


consequences of, 625–626treatment goals for, 626

functional anatomy of, 85–86Gigli saw osteotomy of, for distraction

osteogenesis, 507–509

Midfoot deformity(ies), arthrodesisstabilization of, external fixation for,533–537external fixation frame designs for,

489–490, 509–510with Charcot arthropathy, external

fixation of, 599, 604–605

Midtarsal joint dislocations, 626–627bridge plating for, 626–635


Mini-open arthrodesis, of talus, for avascularnecrosis, 769

Mirtazapine (Remeron), for chronic painmanagement, 398

Mobility, differential, as interdigital neuromacause, 289with ankle osteoarthritis, joint distraction

impact on, 544–545, 549

Modeling, of transverse tarsal joint, 130–133

Modified three-point injection technique, forankle block, 368–370

Monoaminoxidase (MAO) inhibitors, forchronic pain management, 397

Morphine, for chronic pain management,386–387intrathecal, for complex regional pain

syndrome, 411

Mortise radiograph, of anterior anklesubluxation control, 450–451

Morton’s neuroma, 287diagnosis of, 290–291endoscopic decompression of

intermetatarsal nerve for, 297–304advantages of, 303–304anatomy for, 298, 300–301history of, 297pathogenesis of, 297rationale for treatment, 297–298surgical technique, 301–303

endoscopic view of transverseligament, 300–301, 303


instrumentation for, 299, 301intraoperative views of,

299–302uniportal decompression of,

298, 303

‘‘Morton’s syndrome,’’ 555. Seealso Brachymetatarsia.

Mosaciplasty, for stage 4 osteochondral lesionsof talus, 738

Motion, in acute ankle trauma, 584, 588, 593in external fixator design, 433–436in hindfoot deformity correction

planning, 479–481in talocalcaneal joint, as screwlike, 667

x-ray stereography, 666–667in talonavicular joint, x-ray stereography,

669–670

Motor deficits, with peripheral nerveentrapments, 255–256, 262–263, 266

Motor neuropathy, diabetic, 222of tarsal navicular, 147–148

Muller-Weiss disease (MWD), 105–125clinical findings of, 114–115differential diagnosis of, 122–123distribution by date of birth, 108–109epidemiology of, 108–110etiopathogenesis of, 110–112historical perspectives of, 105–108imaging of, 66–67, 69, 71, 115–122,

196–198ankle and hindfoot, 116–117degree of deformity and, 121–122forefoot, 120–121midfoot, 117–120

osteonecrosis role in, 105–106, 108, 114,122–123

pathologic anatomy of, 112–114stages of deformity with, 116–119,

121–122talonavicular-cuneiform arthrodesis for,

65–72conservative treatment versus, 65diagnosis of, 65–66postoperative management of,

68, 71procedure for, 67–71summary of, 65, 71treatment of, 66

versus tarsal navicular stress fracture, 66,105–107

Multi-detector CT (MDCT), for talus imaging,686, 700

Multiple crush hypothesis, of diabeticneuropathy, 242

Multiple drill hole osteotomy, for tibia,505, 507

Muscles, atrophy of, with peripheral nerveentrapments, 255–256, 258–259skeletal, biomechanical response to

distracted bone, 442

Myelomeningocele, talectomy for, 775, 778

N

‘‘N spot,’’ in tarsal navicular stressfractures, 90

Nausea and vomiting, postoperative, avoidingwith regional anesthesia, 350, 352–353

Navicular anatomy, 1–23as accessory bone, 4, 18–20. See also

Accessory navicular.vascularization of, 21

bone morphology, 1–4anterior aspect, 1, 3dorsal aspect, 3lateral end, 4medial end, 4plantar aspect, 4posterior aspect, 1–2

fracture considerations of, 26–27imaging of, 2–20in Muller-Weiss disease,

three-dimensional reconstructionof, 113–115

joints, 2, 4–6ligaments, 4–14


6–10support function, 4–6

tibialis posterior tendon, 13–17

Navicular arthrodesis, 73–83as fracture treatment, 57–60complications of, 77, 81–82

adjacent joint arthrosis as, 82malalignment as, 81–82nonunion as, 77, 81

effects of, 679–680combined with other joint fusions,

679–681goals of, 73, 82indications for, 73–74, 82results of, 75–81talonaviculocuneiform, for acute

neuropathy, 158–160technique for, 74–75, 82

Navicular body fractures, classification of,28–30


dislocations of, 34–35operative treatment of, 43–50

imaging of, 188–190nondisplaced, treatment of, 43–44type 1, 29, 44–45type 2, 29, 45–48type 3, 29, 48–49

Navicular fractures, 25–63anatomy of, 26–27avulsions, 28

treatment of, 41–43classification of, 27–32clinical presentations of, 25, 33–35functional impact of, 25imaging of, 32–33, 36, 188–190nonreconstructible, 35, 56–57of accessory bone, 31–32

treatment of, 50–51of body, 28–30of tuberosity, 31–32

treatment of, 50–51operative treatment of, 35–62

complications with, 60–62dislocations, 51–53external fixation as, 36–39, 56gastrocnemius recession and,

53–54internal fixation as, 29, 35, 43–50K wires for, 38–42, 45–46, 50,

52, 56nonreconstructible challenges, 35,

56–57of accessory fractures, 50–51of avulsions, 41–43of body fractures, 43–50of tuberosity, 50–51patient positioning in, 39, 41postoperative care in, 55–56primary arthrodesis as, 57–60timing of, 36

rehabilitation of, 55–56soft tissue trauma with, 34–35, 56–57stress, imaging of, 190–195

versus Muller-Weiss disease, 66with accessory pathology, 176

treatment of, 26, 35, 62operative, 35–62

Navicular imaging, 181–209anatomical considerations, 181bone scintigraphy, accessory, 171–172,

186–188for osteochondral lesions, 201–202for stress fractures, 91–92,

99–100, 193–195computed tomography scan, 182

for acute trauma, 189–191for bipartite variant, 184–186for fractures, 32–33for osteochondral lesions, 199–202

for osteonecrosis, 197for stress fracture, 88, 92–94,

101–102, 193–194for tarsal coalition, 202–205

conventional radiography, 182–189for fractures, 32–33, 36, 188–190for osteochondral lesions, 198–199for osteonecrosis, 196–198for stress fracture, 191–194for symptomatic accessory, 171,

186–188for tarsal coalition, 202–203routine evaluation guidelines

for, 183special views for, 183–184standard views for, 182–183subject variability in, 182variants with, 184–186with Muller-Weiss disease, 66–67,

69, 71for acute trauma, 188–190for osteochondral lesions, 198–202for osteonecrosis, 196–198for stress fractures, 190–195for tarsal coalition, 202–205initial evaluation guidelines, 181–182magnetic resonance imaging, 182, 188

accessory, 172–173for osteochondral lesions, 200–202for osteonecrosis, 197for stress fractures, 193–195for tarsal coalition, 204–205

nuclear medicine imaging, 182, 184for stress fractures, 193–195

Navicular neuropathy, with tarsal injury,147–164

acute injury treatments, 155–159cellular abnormalities with, 148chronic manifestations of, 149–150

treatment goals for, 159–163clinical presentations of, 147–149incidence associated with

diabetes, 147mechanisms of, 147–148metabolic abnormalities with, 148radiographic patterns with,

148–150Schon classification of, 149–150treatment of, acute injuries,

155–159chronic deformities, 159–163goals for, 152–153, 163nonoperative, 153–155operative, 150–152

Navicular tuberosity fractures, 31–32operative treatment of, 50–51

Nefazodone (Serzone), for chronic painmanagement, 398


Nerve blocks. See also specific anatomyor technique.peripheral. See Peripheral nerve

blocks (PNB).regional, for complex regional pain

syndrome, 412sympathetic blocks, for complex regional

pain syndrome, 406cervical, 408–409lumbar, 407–408T2 and T3, 409–410

Nerve compression, in diabetic neuropathy,241–242, 245

animal studies on, 242–243theories under investigation, 233

in tarsal tunnel syndrome, 275–276physical examination of, 277–278

with peripheral entrapments, 255–256.See also Peripheralnerve entrapments.

Nerve conduction studies, for interdigitalneuroma, 291for superficial peroneal nerve

entrapment, 263for sural nerve entrapment, 266

Nerve decompression. See Endoscopic decom-pression; Surgical decompression.

Nerve entrapment syndromes. See Peripheralnerve entrapments.

Nerve intermuscular transposition, neurectomywith, for interdigital neuroma, 293

Nerve stimulation modalities, for complexregional pain syndrome, peripheral, 412spinal cord, 411–412

Nerves and nerve fibers, biomechanicalresponse to distracted bone, 441–442hypersensitivity of, with diabetic

neuropathy, 223–224injury of, hyperglycemia-induced, 230

in chronic intractable lowerextremity pain, 306

ischemia of, in diabetic neuropathy,229–230, 233

tension of, in tarsal tunnel syndrome, 276physical examination of,

277–278transection of, for chronic intractable

lower extremity pain, 308with containment, 308–310

Neuralgia. See also Neuropathic pain.peripheral, from double crush

phenomenon, 306–307nerve transection with containment

for, 309–310

Neurectomy, for interdigital neuroma,291–293

subsequent nerve intermusculartransposition with, 293

Neuroanatomy, as interdigital neuromacause, 289of metatarsals, 288

Neurolysis, radiofrequency, for complexregional pain syndrome, 408–409revision peripheral nerve, for chronic

intractable lower extremity pain,307–308

with vein wrap, 310–311

Neuromas, in chronic intractable lowerextremity pain, 306

transection with containment,308–310

interdigital, 287–296. See alsoInterdigital neuromas.

Morton’s. See Morton’s neuroma.

Neuromuscular junction, botulinum toxinaction on, 340

Neuropathic arthropathy, diabetic, talectomyfor, 780–781hindfoot malignment with,

supramalleolar osteotomy for, 479of midfoot, fusion and external fixation

for, 535–536

Neuropathic cachexia, 227

Neuropathic injury, of tarsal navicular,147–164






Neuropathic pain, alteration in pain gate,224–225blood flow and, 227, 229–230, 240central spinal sensitization and, 225–226chronic intractable lower extremity,

assessment of, 305electrodiagnostic studies of,

306–307


instrinsic versus extrinsic pathologyof, 305–306

physical examination of, 306symptom complexes of, 306treatment options for, 305,

307–315. See also Peripheralnerve surgery.

definition of, 223, 374diabetic. See Diabetic neuropathy.ectopic electrical impulses and, 226focal, 228medical management of. See

Chronic pain.metabolic factors of, 227, 240–241


nerve hypersensitivity with, 223–224nociceptive, nerve transection

containment of, 309–310nondiabetic, in diabetic patients, 228pathogenesis of, 223–224spinal rewiring with, 225

Neuropathy, diabetic. See Diabetic neuropathy.types of, 305–307

Neurosensory testing, for diabetic neuropathy,postoperative decompression, 251–252

preoperative decompression,248–249, 251

Neutral dorsiflexion, in joint distraction, forankle osteoarthritis, 546, 549–550

Nociceptive pain, definition of, 374nerve transection with containment for,

309–310

Nonmalignant pain, chronic, opioidmanagement of, 394

Nonsteroidal anti-inflammatory drugs(NSAIDs), for chronic pain management,376–377

benzothiazine derivates, 377cardiovascular system and, 380gastrointestinal complications with,

378–379hypertension with, 379–380indoleacetic acid derivates, 377mechanisms of, 376–377propionic acid derivates, 377pyrrolacetic acid derivates, 377renal complications with, 379

for tarsal tunnel syndrome, 279–280

Nonunion, of talar neck fractures, 726,734–735with navicular arthrodesis, 77, 81

for fractures, 61, 102

Nonvascularized allograft, of talus, foravascular necrosis, 763–765

Nonvascularized autograft, of talus, foravascular necrosis, 761–763

Noradrenergic antidepressants, for chronic painmanagement, 398

Norepinephrine reuptake antidepressants, forchronic pain management, 397–398

Norepinephrine reuptake inhibitors, for chronicpain management, 398

Nuclear medicine imaging, of talus,686–687, 700

with arthrography, 691–693

Nuclear medicine imaging (NMI). See alsoBone scintigraphy.of Charcot arthropathy, preoperative

external fixation, 597of navicular, 182, 184

for stress fractures, 193–195

Nursing staff, training for regional anesthesia,350–351

O

Oblique radiography views, of navicular,medial versus lateral, 182–184

Obturator nerve, anatomy of, 359

Open fractures, of talar neck, 733

Open reduction and internal fixation (ORIF),of malleolar fractures, 471of navicular fractures, displaced, with

navicular neuropathy, 157–158tuberosity and accessory, 50–51with body dislocations, 29, 43–50

type 1, 44–45type 2, 45–48type 3, 48–49

of talus, 703–704with neck fractures, 723, 726–732

of tibial pilon fractures, 456complications of, 468–469results of, 469–470with Tscherne soft tissue injury, 460

Opening wedge osteotomy, medial calcaneal,for ankle deformity and arthritis,485–486

in Iizarov technique, for clubfootdeformity correction, 575

rules for, based on foot deformityanalysis, 501–503

Opioid addiction, in chronic pain management,394–395

Opioid dependency, in chronic painmanagement, 394–395


Opioid receptor sensitivity, in diabeticneuropathy, 224

Opioid tolerance, in chronic pain management,394–395

Opioids, for chronic pain management,384–395

addiction to, 394–395administration routes for, 385–386adverse effects of, 391–393

on cardiovascular system, 392on central nervous system, 392on gastrointestinal system,

392–393on immune system, 393on musculoskeletal system, 393on respiratory system, 392on urinary system, 393

agonist-antagonists, 386, 391codeine, 387–388drug selection, 386, 393–394endogenous forms of, 385fentanyl, 388–389hydromorphone, 387indications for, 385levorphanol, 390mechanism classifications of,

385–386meperidine, 390methadone, 389morphine, 386–387nonmalignant pain, 394oxycodone, 388oxymorphone, 390partial agonists, 386, 391physical dependency on, 394–395propoxyphene, 390receptors types for, 384–385tolerance of, 394–395withdrawal symptoms, 395

interaction with regional anesthesia, 359intrathecal, for complex regional pain

syndrome, 411

Organic pain, definition of, 374

Orthofix fixator, for external fixation,440–441

in ankle fusions, 434, 531

Orthotics, external fixation and, for cavusfoot, 613

for foot and ankle fusions, 531, 536for residual clubfoot in

adolescents, 581for accessory navicular, 173–174for tarsal tunnel syndrome, 279–280for transverse tarsal joint, 139–144

Os supravaviculare, radiography of, 184

Os trigonum, of talus, 787–796

diagnosis of, 788–789fracture of, 718imaging of, 688–689, 789injury mechanism, 788, 794nonsurgical management of,

789–790normal versus pathologic, 789pathoanatomy of, 787–788surfaces of, 788surgical management of, 790–794

arthroscopic approach, 707,791–792

lateral approach, 793–794medial approach, 792–793

Os trigonum syndrome, 788, 790

Ossification, deficiency of metatarsal,brachymetatarsia from, 555, 557delay of tarsal navicular, Muller-Weiss

disease from, 110–112of posterior talus process, 787

nonfusion of. See Os trigonum.

Ostectomy, for navicular neuropathy, 160–162

Osteoarthritis. See Ankle osteoarthritis (AO).

Osteoarticular structure loss, as external fixa-tion indication, for acute ankle trauma,584–587

Osteochondral allografts, for stage 4osteochondral lesions of talus, 743

Osteochondral autologous transplantation(OATS), for stage 4 osteochondral lesionsof talus, 738–740

discussion on, 742–743operative procedure, 740–741results of, 741–742viability of fresh grafts, 743

Osteochondral lesions, navicular, imaging of,198–202

Osteochondral lesions of talus (OLT),arthroscopic treatment of, 705–707avascular necrosis versus, 757imaging of, 686, 691–693stage 1, 737stage 2, 737stage 3, 737stage 4, 737stage 5, 737stage VI massive, 737–744

classification comparisons, 737pathology of, 738–739treatment options for, 737–738

Osteogenesis, distraction, external fixation for,489–528. See also Distractionosteogenesis; External fixation.


Osteomyelitis, chronic tibiotalar joint, fusionand external fixation for, 533midfoot fusions and, external fixation

for, 536of talus, imaging of, 698–699with navicular neuropathy, 162–163

Osteonecrosis, navicular, as arthrodesisindication, 74

following arthrodesis, 81imaging of, 196–198in Muller-Weiss disease, 105–106,

108, 114, 122–123of talus, 745–755

atraumatic, 746–747, 749clinical presentation of, 750differential diagnosis of, 749etiology of, 747–749historical terms for, 745imaging of, 750–753incidence of, 745–747staging of, 752–753traumatic, 5, 745–746vascular anatomy and, 747–749

Osteophytes, in ankle osteoarthritis, jointdistraction consideration of, 541,545, 549–550peripheral nerve entrapments from, 255,

257, 260

Osteoporosis, midfoot fusions and, externalfixation for, 532–533

Osteotomes, for ankle fusions, 530

Osteotomy(ies), for distraction osteogenesis,external fixation and, 492, 506–509for talus fracture management,

714–715, 720medial malleolar, 704–706

in cavus foot correction, for bonydeformity, 612, 618

in Iizarov technique, for clubfootdeformity correction, 575–576

in metatarsal lengthening forbrachymetatarsia, gradual,564–566one-stage, 558–564preferred procedure for, 567–568

rules for, based on foot deformityanalysis, 501–504

supramalleolar.See Supramalleolar osteotomy.

Oxacarbazepine, for chronic painmanagement, 384

Oxycodone, for chronic pain management, 388

Oxymorphone, for chronic painmanagement, 390

P

Pain, chronic. See Chronic pain.complex regional. See Complex regional

pain syndrome (CRPS).gate mechanism of, 280

alteration in diabetic neuropathy,224–225

nerve-based. See Neuropathic pain.with ankle osteoarthritis, joint distraction

impact on, 544–545with brachymetatarsia, 558, 567with Muller-Weiss disease,

114–115, 117with navicular fractures, 33–34

postoperative, 60–61tarsal stress, 90

with tarsal tunnel syndrome, 276–277anterior, 255, 258–259, 262–265

with weight bearing, as naviculararthrodesis indication, 73–74

Paralytic deformity, tendon transfers for,319–337

anatomy of, 320–322biomechanics of, 322–325causes of deformity, 320historical evolution of, 319–320physiology of, 325–326principles and timing of, 326–328

arthrodesis versus, 327–328fixed versus flexible, 327static versus progressive, 326subcutaneous, 324–325

relative strength comparisons,322–323

techniques for, 325, 328–336bridle procedure, 331–332multiple transfers to

calcaneus, 332–333new fixations, 335–336nonstandard, 333–335posterior tibial tendon,

328–331stirrup procedure, 332tenodesis of extensors to

tibia, 332triple arthrodesis versus, 327–328

Paroxetine (Paxil), for chronic painmanagement, 397

Patellar tendon-bearing (PTB) brace, for talus,with avascular necrosis, 758–759

Patient safety, with regional anesthesia, forlower extremity, 354

Percutaneous fixation, of talar neck fractures,728–730

Periarticular anatomy, 1–23accessory navicular bone, 4, 18–20

vascularization of, 21


bone morphology, 1–4anterior aspect, 1, 3dorsal aspect, 3lateral end, 4medial end, 4plantar aspect, 4posterior aspect, 1–2

joints, 2, 4–6ligaments, 4–14


6–10support function, 4–6

soft tissue evaluation, for supramalleolarosteotomy, 483–484

tibialis posterior tendon, 13–17

Peripheral nerve blocks (PNB), for chronicintractable lower extremity assessment,306–307for lower extremity, 359–366

3:1 inguinal lumbar plexustechnique, 361–362

anatomy considerations, 359–360ankle techniques, 366guidelines, 367lumbar plexus techniques,


plexus, 360–362patient management following,

367–368proximal to distal list of, 352saphenous techniques, 365–366sciatic techniques, 362–365


setup time for, 357–358

Peripheral nerve entrapments, 255–269anterior tarsal tunnel syndrome, 256–261clinical stages of, 255–256definition of, 255etiologies of, 256in diabetic neuropathy, 241–242, 245

animal studies on, 242–243decompression of. See Surgical

decompression.theories under investigation, 233

of superficial peroneal, 261–264of sural nerve, 264–267

Peripheral nerve stimulation (PNS), forchronic intractable lower extremity pain,311–315

with nerve transection, 309for complex regional pain syndrome, 412

Peripheral nerve surgery, decompression,for diabetic neuropathy.See Surgical decompression.revision, for chronic intractable lower

extremity pain, 305–318amputation as, 315assessment of, 305electrodiagnostic studies of,

306–307instrinsic versus extrinsic

pathology of, 305–306nerve transection as, 308

with containment,308–310

neurolysis, revision as,307–308with vein wrap,

310–311peripheral nerve stimulator

for, 311–315physical examination of, 306symptom complexes of, 306treatment options, 305

Peripheral vascular disease, in diabeticneuropathy, 230

Peritalar joint, clinical biomechanics of,663–683. See also specific joint.

alignment effects on, 672–678anatomy of, 663–664, 681–682ankle joint fusion effects on,

678–679axes of rotation, 664calcaneocuboid joint fusion effects

on, 680–681combined arthrodeses effects

on, 681joint fusion effects on, 678–681normal, 664–672talocalcaneal joint, alignment effect

on, 672–674, 676–677joint fusion effects on, 679normal, 664–667, 670–672

talonavicular joint, alignment effecton, 674–678joint fusion effects on,

679–680normal, 667–670

Peroneal nerves, anatomy of, 360deep. See Deep peroneal nerve.entrapment of superficial. See Superficial

peroneal nerve entrapment.in diabetic neuropathy, surgical

decompression of, common,245–246

deep, 246–247

Peroneal tendons, in tendon transfers, forparalytic deformity, 321–322

Pes cavus, with flatfoot, 138–139


Pes planus deformity, accessory navicular rolein, 168–170

surgical treatment of, 174–179

adult, posterior tibial tendon dysfunctionin, 674

effect on kinematics, of talocalcanealjoint, 672–674

of talonavicular joint, 674–676

effect on kinetics, of talonavicular joint,677–678

with Muller-Weiss disease, 65–66, 119

Pes plenovalgus deformity, as naviculararthrodesis indication, 74

‘‘Phantom pain,’’ with diabetic neuropathy,225–226

Pharmacological management, of chronic pain,375–400

acetaminophen for, 375–376

antiarrhythmics for, 399–400

antidepressants for, 395–398

antiepileptics for, 380–384

centrally-acting agents for,398–399

COX-2 selective inhibitors for,378–380

goals of, 375

local anesthetics for, 399–400

multidisciplinary approach to, 375

nonsteroidal anti-inflammatorydrugs for, 376–377

opioids for, 384–395

of complex regional pain syndrome,intrathecal agensts, 410–411

of tarsal tunnel syndrome, 279–280

Phenytoin, for chronic pain management,380–381

Physeal distraction, histology of, 441

Physical therapy, for os trigonum, 790of lower extremity, after botulinum toxin

injection, 343–345

Physiotherapy, for tarsal tunnel syndrome, 280

Pilon fractures, tibial, external fixation for,455–470

anterior ankle subluxationcontrol and, 449

complications of, 467–469

evaluation of, 456–459

evolution of, 455–456

goals of, 459–460

results of, 469–470

techniques for, 459–467

conventional, 459–462

hybrid, 462–467

innovative, 646

Pin fixation, for acute ankle trauma, 585–588,590, 592for anterior ankle subluxation control,

Anderson’s technique for, 449, 451indications for, 449recent innovative technique for,

449–450, 453for foot and ankle fusions, 530historical acceptance of, 637in Iizarov technique, for clubfoot

deformity correction, 576–580innovations and future directions in,

637–640, 643–645of Charcot arthropathy, 599–600,

605–607complications of, 601, 604, 608

of tibial pilon fractures, 463–465

Pin track infections, with external fixation,531, 552, 626

innovative prevention of, 639–640of tibial pilon fractures, 463, 468

Pinless fixators, joint-bridging, for acute ankletrauma, 592–593

for malleolar fractures, 471

Plantar calcaneonavicular ligament, anatomyof, 5–6

Plantar digital nerves, anatomy of, 287–288

Plantar fasciectomy, Tachdjian, for soft tissuecavus contractures, 612–615

Plantar nerves, in tarsal tunnel syndrome, 273operative treatment of, 280–281

Plantarflexion, as os trigonum mechanism,788, 790

Plantarly directed nerve branches(PDNBs), 288

Plate fixation, as external fixation alternative,625–636

advantages of, 625, 635–636barrel hoop plating, illustrative

case, 633–635surgical technique for,

631, 633bridge plating, 626–635

complications of, 635indications for, 627, 636lateral, illustrative case,

629–632surgical technique

for, 629medial, illustrative case, 628

surgical technique for,627–628

postoperative management of,633–635

principles of, 626–627


with barrel hoop plate,633–635

for midfoot injuries, 625–626for malleolar fractures, 471for talectomy, 781, 783for tibial pilon fractures, 463–465

complications of, 468–469results of, 469–470with Tscherne grade II soft tissue

injury, 461, 463in navicular arthrodesis, 75, 79innovations and future directions in, 646of talar neck fractures, 731

PMMA beads, in acute ankle traumatreatment, 639

for crush injuries, 593tibial pilon fractures, 464

Poliomyelitis, talectomy for, 777

Polyol pathway, in diabetic neuropathy,230–231

Popliteal fossa nerve block, for lower extremityanesthesia, 364

Positron emission tomography (PET), for talusimaging, 686–687, 700

with arthrography, 691–693

Post-Anesthesia Care Unit (PACU),‘‘fast-tracking’’ patients to minimizeuse of, 350, 354

Posterior medial talus fractures, 718–720pathology of, 718–719treatment of, 719–720

Posterior talus process, fracture of, 788ossification center of, 787

nonfusion of. See Os trigonum.

Posterior tibial nerve, in modified three-pointinjection technique, for ankle block,368–369primary, 271–285. See also Tarsal

tunnel syndrome.

Posterior tibial tendon (PTT), accessorynavicular relationship to, 165–166

anatomical classifications in,166–167

clinical presentations of, 170–171conservative management of,

173–174pathologic states of, 168–169surgical treatment of, 174–179

transfer for paralytic deformity, anatomyof, 320–322force couple considerations,

321–322historical evolution of, 320physiology of, 325–326


techniques for, 328–331nonstandard, 333–335

triple arthrodesis versus, 327–328

Posterior tibial tendon dysfunction, in adultflatfoot deformity, 674

Posterior tibial tendon insufficiency (PTTI), asnavicular arthrodesis indication, 74

results of, 77–79, 81–82

Posterior tibialis muscle-tendon unit, anatomyof, 13–16dysfunctional impact of, 17function of, 17

Posteromedial approach, to talus surgery, 707

Postoperative nausea and vomiting (PONV),avoiding with regional anesthesia, 350,352–353

Posttraumatic arthrosis, with navicularfractures, 61–62

Pregabalin, for chronic pain management, 384

Pressure-specified sensory device (PSSD), forneurosensory testing, with diabeticneuropathy, postoperative, 251–252

preoperative, 248–249, 251

Procaine, interaction with regionalanesthesia, 356

Procurvatum deformity, 497, 511

Pronation compensation, as foot deformity,495–497

Propionic acid derivates, for chronic painmanagement, 377

Propofol, with regional anesthesia, 355

Propoxyphene, for chronic painmanagement, 390

Prostheses, reconstructive, talectomy for, 778

Protein kinase C (PKC) theory, of diabeticneuropathy, 232

Proteolycans, in ankle osteoarthritis, 542–543

Provocative maneuvers, for superficialperoneal nerve entrapment, 263

Proximal axes, in deformity analysis, 500–507

Proximal tarsal tunnel, anatomy of, 271–273

Psoas compartment lumbar plexus nerve block,for lower extremity, 360–362

Psychogenic pain, definition of, 374

Pyrolacetic acid derivates, for chronic painmanagement, 377


Q

Quadrangular frame, for external fixation, oftibial pilon fractures, 466

R

Radiofrequency neurolysis, for complexregional pain syndrome, cervical, 409

lumbar, 408

Radiography, conventional navicular, 182–189for fractures, 32–33, 36, 188–190for osteochondral lesions, 198–199for osteonecrosis, 196–198for stress fracture, 88, 90–91,

190–194for symptomatic accessory, 171,

186–188for tarsal coalition, 202–203routine evaluation guidelines

for, 183special views for, 183–184standard views for, 182–183subject variability in, 182variants with, 184–186with Muller-Weiss disease, 66–67,

69, 71for anterior ankle subluxation control,

450–453for foot deformity evaluation, 495,

497–500for talus imaging, 685–686

in postoperative patient,699–700, 742

of os trigonum, 789of osteonecrosis, 750–752with fractures, 711–712, 716

of talar neck, 725–726with pathology, 689–691,

693–694, 696–699of interdigital neuroma, 291of joint distraction, for ankle

osteoarthritis, 548–550of sural nerve entrapment, 266of tarsal tunnel syndrome, 278–279

anterior, 260

Radiotracers, for talus imaging, 686–687, 700

Range of motion. See Biomechanics.

Reactive oxygen intermediate theory, ofdiabetic neuropathy, 231–232

Reactive oxygen species (ROS), in diabeticneuropathy, 231–232

Reconstruction techniques, for talus fractures,714–716, 721talectomy for, 778

Reduction, of talus fractures, crush, 721

lateral process, 717–718posteriormedial, 720talar body, 714–716talar head, 712–713

unstable of dislocations, as externalfixation indication, 587–591

Reduction tong, for midfoot crush injuries, 633

Reflex sympathetic dystrophy (RSD).See also Complex regional painsyndrome (CRPS).amputation for neuropathic pain

with, 315definition of, 405

Regional anesthesia (RA), for lower extremity,349–372

avoiding postoperative nausea andvomiting, 350, 352–353

critical questions for, 349–350duration increase, 358–359‘‘fast-tracking’’ patients to

minimize postanesthesiacare unit resources, 350, 354

guidelines for, 367local anesthetics and, 355–357

to mix or not to mixcontroversy, 357

minimizing controlled time andmaximizing operative time,349, 351–352

moving to operating room aftersuccessful placement,351–352

onset time decrease, 357–358patient safety with, 354performing in special preoperative

area with trained nursing staff,350–351

peripheral nerve blocks and,359–3663:1 inguinal lumbar plexus

technique, 361–362anatomy considerations,

359–360ankle techniques, 366guidelines, 367lumbar plexus techniques,


plexus, 360–362patient management

following, 367–368proximal to distal list of, 352saphenous techniques,

365–366sciatic techniques, 362–365

anterior, 363distal, 364lateral, 364–365


posterior, 363–364proximal, 363single versus

double, 365setup time for, 358Winnie technique, 361–362

sedation with, 354–355using for postoperative analgesia,

350, 352–353using in preference to general

anesthesia, 350

Regional nerve blockade, for complex regionalpain syndrome, 412

Regional pain. See Complex regional painsyndrome (CRPS).

Rehabilitation, postoperative, of navicularfractures, 55–56

stress, 100–102

Revision neurolysis, for chronic intractablelower extremity pain, 307–308

with vein wrap, 310–311

Revision surgery, of peripheral nerve,305–318. See also Peripheralnerve surgery.

Ring fixation, external, biomechanical designsfor, 434–435

for soft tissue cavus contractures,615–617

of tibial pilon fractures, 456, 463complications of, 467–469results of, 469–470i

Rocker-bottom deformity, with Charcotarthropathy, external fixation of,599–600, 608with navicular neuropathy, 149–150

nonoperative treatment of, 155surgical correction of, 151–152,

157–158

Rod fixation, carbon-fiber, for anterior anklesubluxation control, 449–450, 452for talectomy, 783

Rofecoxib (Vioxx), for chronic painmanagement, 378

Rollabout device, for external fixation, ofCharcot arthropathy, 600–601, 607

Ropivacaine, interaction with regionalanesthesia, 357

Rotation, axes of, in deformity measurement,492–500center of, in deformity analysis, 500–507distal tibia external frame designs for,

640–642

Ruedi type 3 injury, of soft tissue with tibialpilon fractures, 456

external fixation techniques for,459–467complications of, 467–469results of, 469–470

Rule of similar triangles, for distractionosteogenesis, 511–512

S

Sagittal plane motion, in peritalar jointbiomechanics, 664

Salvage procedures, midfoot, external fixationfor, 533of talus, for avascular necrosis, 768–771

talectomy for, 775, 777–778

Sangeorzan classification, of navicular bodyfractures, 29–30

Saphenous nerve, anatomy of, 360

Saphenous nerve blocks, 365–366modified three-point injection technique,

for ankle block, 370

Schantz screws/pins, for external fixation, ofacute ankle trauma, 591

of ankle osteoarthritis, 546of anterior ankle subluxation,

450, 452

Schon classification, of navicular neuropathy,149–150

Schon procedure, for accessory navicular,175–176

Sciatic nerve, anatomy of, 359–360

Sciatic nerve blocks (SNB), for lowerextremity, 362–365


Scintigraphy, for talus imaging, 686–687, 700of os trigonum, 789of osteonecrosis, 752

Screw fixation, for accessory navicular,174–179for talonaviculocuneiform arthrodesis,

with acute neuropathy, 158–161for unstable reduction of dislocations,

with acute ankle trauma, 587–591in navicular arthrodesis, 75–78, 80–81innovations and future directions in,

637–640, 643–646


of malleolar fractures, 471of navicular fractures, 43–48, 50–52

stress, 96–98, 100of talus, 704

with arthrodesis, 770–771with neck fractures, 730–732with talectomy, 780–781, 783

of tibial pilon fractures, 463–465complications of, 467–469results of, 469–470with Tscherne grade II soft tissue

injury, 457–461

Screwlike motion, of talocalcaneal joint, 667

Sedation, with regional anesthesia, for lowerextremity, 354–355

Selective serotonin reuptakeinhibitors (SSRIs), for chronic painmanagement, 397

Semmes-Weinstein monofilaments (SWM),in neurosensory testing, for diabetic

neuropathy, 248–249, 252

Sensory deficits, with peripheral nerveentrapments, 255–256, 258, 260,262–263

Sensory neuropathy, of tarsal navicular,147–148

Septic arthritis, from external fixation, 463

Serotonin 2 receptor antagonism, for chronicpain management, 398

Serotonin reuptake antidepressants, for chronicpain management, 397–398

Serotonin reuptake inhibition, for chronic painmanagement, 398

Serotoninergic antidepressants, for chronicpain management, 398

Shear fractures, of talar head, 710–712

‘‘Shepherd’s’’ fracture, as os trigonummechanism, 788

Shoe wear, constrictive, peripheral nerveentrapments from, 255, 258modifications of, for accessory navicular,

173–174for interdigital neuroma, 291for navicular neuropathy, 155, 163

Similar triangles, rule of, for distractionosteogenesis, 511–512

Skeletal muscle, biomechanical response todistracted bone, 442

Skin flaps, for reconstruction and externalfixation, 591–593

Skin integrity, distraction osteogenesisconsideration of, 512

Slide osteotomy, in metatarsal lengthening forbrachymetatarsia, 564

‘‘Snowboarder’s’’ fractures, of talus, 716–718

Sodium channels, in diabetic neuropathy,ectopic electrical impulses and, 226

tetrodotoxin-resistant, 223–225

Soft tissue, biomechanical response todistracted bone, 441–442cavus contractures of, external fixation

for, 615–619

gradual distraction techniquein, 612–615

treatment algorithm for, 611–612

contractures of, correction for Ilizarovexternal fixation, 436–437

innovative fixation strategies for,642, 644–645

joint distraction consideration of,545–546, 639

with distraction osteogenesis,external fixation and,510–511

in Ilizarov technique, for clubfootdeformity correction, 576

lengthening of, in metatarsal lengtheningfor brachymetatarsia, 559, 564, 568

periarticular evaluation, for supramalleo-lar osteotomy, 483–484

reconstruction of, as external fixationindication, 591–592

innovative external fixation for,638, 642

Soft tissue injury(ies), as external fixationindication, for acute ankle trauma,584–587tarsal tunnel syndrome from, 274

treatment of, 279–280

with malleolar fractures, 470–471

with midfoot injuries, 626–627, 629,633, 635

bridge plating for, 627–635lateral, 629–632medial, 627–628

with navicular fractures, 34–35, 56–57

with tibial pilon fractures, 455–459

external fixation consideration of,459–467

Soleus muscle, botulinum toxin injection in,for toe walking, 341–346

Sorbitol pathway, in diabetic neuropathy, 230,232–233


Space-occupying lesions, in peripheral nerveentrapments, 255–256. See alsospecific syndrome.tarsal tunnel syndrome from, 274

anterior, 255–256, 260nonoperative treatment of, 280operative treatment of, 280–281

Spinal cord stimulation (SCS), for complexregional pain syndrome, 411–412for neuropathic pain, 315

Spinal headaches, avoiding with regionalanesthesia, 350

Spinal rewiring, with diabetic neuropathy, 225

Spinal sensitization, central, with diabeticneuropathy, 225–226

Spring ligament, anatomy of, 5–6, 9insufficiency in flatfoot deformity,

135–137orthotic control of, 141–144

of transverse tarsal joint, 129–130

Standing AP foot radiograph, for deformityevaluation, 495, 497

Standing lateral foot radiograph, for deformityevaluation, 495, 498

Steroid injections, for os trigonum, 790

Stirrup procedure, for tendon transfers, forparalytic deformity, 332

Strain, in acute ankle trauma, 584, 588, 593

Stress fractures, of tarsal navicular, 85–104anatomy considerations, 85–88bone strain and, 88case presentation of, 88–89classification system for, 85, 94clinical presentation of, 88–90imaging of, 88–94, 190–195incidence of, 85pathophysiology of, 85–88treatment of, 94–102

basis of, 85, 94–95, 102–103complications of, 102conservative, 95–96rehabilitation following,

100–102surgical indications for,

96–98surgical technique in, 98–100

versus Muller-Weiss disease, 66with accessory pathology, 176

Styf test, for superficial peroneal nerveentrapment, 263

Subluxation, with navicular neuropathy,149–150

with shear fractures, of talar head,710–711

Substance P, in diabetic neuropathy, 225

Subtalar joint (STJ), anatomy of, 663biomechanics of, 130–134dislocations of, 733–734pathologic conditions of, 134–139

arthritis and arthrodesis, 134–135compensatory mechanisms and

secondary changes, 137–139flatfoot deformity, 135–137orthotic control for, 139–144

Superficial peroneal nerve entrapment,261–264anatomy for, 261

variations in, 261–262conservative treatment of, 263etiology of, 262evaluation of, 262–263

clinical, 262–263conduction tests, 263differential diagnosis, 263imaging, 263patient history, 262

introduction to, 261surgical treatment of, 264

Superomedial calcaneonavicular ligament(SMCN), anatomy of, 6–10in transverse tarsal joint, 129–130, 137

Supination mechanics, as foot deformitycompensation, 495–497

Supramalleolar osteotomy, for ankle deformityand arthritis, 475–487

complications of, 486congenital deformities and,

475–476deformity connection, 476–477developmental deformities and,


Gigli saw, for distraction osteogenesis,506–509

Sural nerve entrapment, 264–267anatomy for, 264–265

variations in, 265conservative treatment of, 266etiology of, 265–266evaluation of, 265–266

clinical, 265–266differential diagnosis, 266electrodiagnostic testing, 266


imaging, 266patient history, 265

introduction to, 264surgical treatment of, 267

Surfaces, joint. See Articular surfaces.

Surgical approaches, to talus, 703–708. Seealso specific pathology or technique.

arthroscopic, 705–707indications for, 703lateral alternatives, 707–708medial, 708open reduction and internal

fixation, 703–704posteromedial, 707

Surgical decompression, endoscopic.See Endoscopic decompression.for diabetic neuropathy, 239–254

animal studies on, 242–243authors’ experience, 245biomechanical factors, 241–242causes of, 239–240chart review, 250–251common peroneal nerve in,

245–246deep peroneal nerve in, 246–247discussion, 239, 252double crush hypothesis, 242human results, 243–244indications for, 249metabolic factors, 240–241neurosensory testing in,

postoperative, 251–252preoperative, 248–249, 251

operative technique, 245postoperative care for, 248results review, 249–250tarsal tunnel in, 247–248vascular factors, 240

for sural nerve entrapment, 267for tarsal tunnel syndrome, anterior,

260–261superficial peroneal nerve, 264

Surgical treatment. See specific anatomy,pathology, or procedure.

Symmetrical diabetic neuropathy, 221–222

Sympathetic blocks, for complex regional painsyndrome, 406

cervical, 408–409lumbar, 407–408T2 and T3, 409–410

Sympathetic neuropathy, of tarsalnavicular, 148

Synchondrosis, of PTT, accessory navicularrole in, 169–171

surgical treatment of, 174–179

Synchondrosis and lateral process oftalus (SOT angle), in accessorynavicular bone, 20

Syndactylization, for brachymetatarsia, 558

Syndesmology, in acute ankle trauma,583–584, 588, 593in midfoot crush injuries, 630–631

Synovial cyst, as interdigital neuroma cause,289–290

Synovitis, in ankle osteoarthritis, 542–543traumatic, tarsal tunnel syndrome

from, 274

Synthetic substitues, in metatarsal lengtheningfor brachymetatarsia, one-stage, 559, 564

T

T2 sympathetic blockade, for complex regionalpain syndrome, 409–410

T3 sympathetic blockade, for complex regionalpain syndrome, 409–410

Tachdjian plantar fasciectomy, for soft tissuecavus contractures, 612–615

Talar beak, imaging of, 689–691

Talar body, anatomy of, 775–776fractures of, 714–716

pathology of, 714talectomy for, 779treatment algorithm for, 757–758treatment approaches for, 714–716

Talar dome, in foot deformity measurement,493–494

Talar head, anatomy of, 775–776articulation of, in Muller-Weiss disease,

112–114, 116–117in transverse tarsal joint, 128–129

fractures of, 709–713pathology with, 709–711treatment approaches for, 711–713,

757–758

Talar neck, anatomy of, 775–776fractures of, 723–736

anatomy and, 724–725blood supply and, 724–725complications of, 726, 734–735diagnosis of, 725–726history of, 723–724mechanism of, 725open, 733osteonecrosis following, 745–746postoperative treatment of,

731–732


staging of, 726–727subtalar dislocations, 733–734treatment of, 726–731, 757–758

Talectomy, 775–785anatomy for, 775–776current applications of, 775, 778–783fixation techniques for, 780–781,

783–784for talar neck fractures, 726history of, 776–778

Talocalcaneal joint (TCJ), anatomy of, 2,4–5, 663effects of fusion of, 679

combined with other jointfusions, 681

kinematics of, 664–667alignment effect on, 672–674articular surfaces shapes, 664–665axis of rotation, 665–666screwlike motion, 667x-ray stereography of motion,

666–667kinetics of, 670–671

alignment effect on, 676–677

Talocalcaneonavicular joint (TCNJ), anatomyof, 4–5, 7, 663

Talocrural joint, anatomy of, 663–664

Talonavicular-cuneiform (TNC) arthrodesis,for navicular neuropathy, 158–160in Muller-Weiss disease, 65–72

conservative treatment versus, 65diagnosis of, 65–66postoperative managment of, 68, 71procedure for, 67–71summary of, 65, 71treatment of, 66

Talonavicular joint (TNJ), 127–145anatomy of, 2, 4–5, 128–130, 663arthrodesis of. See Navicular arthrodesis.biomechanics of, 130–134kinematics of, 667–670

alignment effect on, 674–676articular surfaces shapes, 667–668axis of rotation, 668–670x-ray stereography of motion,

669–670kinetics of, 671–672

alignment effect on, 677–678orthotic control of, 139–144pathologic conditions of, 134–139

Talus, anatomy of, 775–776avascular necrosis of, 757–773. See

also Osteonecrosis.arthrodeses for, 768–771

complications of, 771

core decompression results,760–761

core decompression technique, 760current treatment options,

757–759, 772imaging of, 687, 693–694nonvascularized allograft for,

763–765nonvascularized autograft for,

761–763salvage procedures for, 768–771vascularized bone graft for,

765–768with talar neck fractures, 724, 726,

731–732, 734–735fracture management of, 709–722

algorithm for, 757–758crush fractures, 710–711, 720imaging for, 694–696lateral process fractures, 716–718outcomes, 711pathoanatomy in, 709posterior process, 788posteriormedial fractures, 718–720talar body fractures, 714–716talar head fractures, 709–713

imaging of, 685–701CT scans, 686MRI, 687–688normal variations with associated

pathology, 688–699arthritis, 693avascular necrosis, 693–694fracture, 694–696os trigonum, 688–689, 789osteochondral lesions,

691–693osteomyelitis, 698–699talar beak, 689–691tarsal coalition, 689–691tumor, 696–698

nuclear medicine-positron emissiontomography, 686–687

postoperative patient evaluation,699–700

radiography, 685–686weight-bearing for talonavicular

joint, 686, 689in foot deformity measurement,

492–500, ‘492–500osteotomy rules for, 500–505

os trigonum of, 787–796diagnosis of, 788–789fracture of, 718imaging of, 688–689, 789injury mechanism, 788, 794nonsurgical management of,

789–790normal versus pathologic, 789pathoanatomy of, 787–788


surfaces of, 788surgical management of, 790–794

arthroscopic approach, 707,791–792

lateral approach, 793–794medial approach, 792–793

osteochondral defects of. See Osteochon-dral lesions of talus (OLT).

osteonecrosis of, 745–755atraumatic, 746–747, 749clinical presentation of, 750differential diagnosis of, 749etiology of, 747–749historical terms for, 745imaging of, 750–753incidence of, 745–747staging of, 752–753traumatic, 745–746, 749vascular anatomy and, 747–749

surgical approaches to, 703–708.See also specific pathologyor technique.arthroscopic, 705–707indications for, 703lateral alternatives, 707–708medial, 708open reduction and internal

fixation, 703–704posteromedial, 707

Tarsal coalition, imaging of, 689–691navicular, imaging of, 202–205supramalleolar osteotomy for, 479

Tarsal navicular, fractures of, bridge platingfor, 626, 631, 633–634

stress, 85–104neuropathic injury of, 147–164






ossification delay of, Muller-Weissdisease from, 110–112

stress fractures of, 85–104anatomy considerations, 85–88bone strain and, 88

case presentation of, 88–89classification system for, 85, 94clinical presentation of, 88–90imaging of, 88–94, 190–195incidence of, 85pathophysiology of, 85–88treatment of, 94–102

basis of, 85, 94–95, 102–103complications of, 102conservative, 95–96rehabilitation following,

100–102surgical indications for,

96–98surgical technique in, 98–100

versus Muller-Weiss disease, 66,105–107

with accessory pathology, 176

Tarsal process fractures, bridge plating for,629–630

Tarsal tunnel syndrome, 271–285anatomy of, proximal versus distal,

271–273anterior, 256–261

complete versus partial, 258compression sites, 258conservative treatment of, 260deep peroneal nerve anatomy,

256–257variations in, 257

etiology of, 257–258evaluation of, 258–260

clinical, 258–259differential diagnosis,

259–260electrodiagnostic testing, 260imaging in, 260patient history, 258

introduction to, 256surgical treatment of, 260–261

clinical presentation of, 276diagnosis of, 278–279distal, 273etiologies of, 273–275history of, 276–277in diabetic neuropathy, surgical

decompression of, 247–248pathophysiology of, 275–276physical examination for, 277–278summary of, 271, 282treatment of, 279–281

anti-inflammatory medication, 280corticosteroids for, 280immobilization as, 279–280nonoperative, 279–280operative, 280–281orthotics as, 279–280physiotherapy as, 280stockings as, 280


Tarsal V-osteotomy, in Iizarov technique, forclubfoot deformity correction, 575

TAS angle, in hindfoot deformity correctionplanning, 479

Taylor spatial frame, for distractionosteogenesis, 489–490, 509–510

center of axis and, 504, 507structure at risk and, 512

innovative external frame designsversus, 642

Technetium 99m-MDP scintigraphy, for talusimaging, 686, 700

Tendon(s), metatarsal, anatomy of, 288

Tendon lengthening, in joint distraction,Ilizarov technique versus, 571–573, 578

Tendon transfers, for accessory navicular,174–176, 178–179for cavus foot, external fixation and,

613, 615for flatfoot deformity, 136–137for paralytic deformity, 319–337

anatomy of, 320–322biomechanics of, 322–325causes of deformity, 320historical evolution of, 319–320physiology of, 325–326principles and timing of, 326–328

arthrodesis versus, 327–328fixed versus flexible, 327static versus progressive, 326subcutaneous, 324–325


techniques for, 325, 328–336bridle procedure, 331–332multiple transfers to

calcaneus, 332–333new fixations, 335–336nonstandard, 333–335posterior tibial tendon,

328–331stirrup procedure, 332tenodesis of extensors to

tibia, 332triple arthrodesis versus, 327–328

Tenodesis, of tibial extensors, for paralyticdeformity, 332

Tetracaine, interaction with regionalanesthesia, 356

Tetrodotoxin-resistant (TTX) sodium channels,in diabetic neuropathy, 223–225

ectopic electrical impulses and, 226

Thoracic sympathetic chain blockade, for com-plex regional pain syndrome, 409–410

Three-dimensional reconstruction, of naviculardeformity, in Muller-Weiss disease,113–115

Three-point injection technique, modified, forankle block, 368–370

Three-point mold, for transverse tarsal jointcontrol, 142–144

Tiagabine, for chronic pain management, 383

Tibia, avascular necrosis of, hindfootmalignment with, supramalleolarosteotomy for, 479congenital torsion of, supramalleolar

osteotomy for, 475–476distal, innovative external frame designs

for, 640–642fixation techniques for, in anterior ankle

subluxation control, 449–453fracture malunion, innovative fixation

strategies for, 642–643in foot deformity measurement, 492–500

mid-diaphyseal line, 492–494normal joint angles of, 499–500osteotomy rules for, 500–507

malunion of, supramalleolar osteotomyfor, 477

Tibial nerves, anatomy of, 360in tarsal tunnel syndrome, 272–273, 276

decompression of diabeticneuropathy and, 245,247–248

operative treatment of, 280–281physical examination of, 277–278

posterior primary, 271–285. See alsoTarsal tunnel syndrome.

risks in foot deformity, 511–512

Tibial pilon fractures, external fixation for,455–470

anterior ankle subluxation controland, 449

complications of, 467–469evaluation of, 456–459evolution of, 455–456goals of, 459–460results of, 469–470techniques for, 459–467


Tibialis posterior tendon, anatomy of, 13–17

Tibio-calcaneo-naviculo-cuboideal (TCNC)arthrodesis, in IIizarov technique, forclubfoot deformity correction, 574–575

Tibiocalcaneal arthrodesis, talectomy for,779–781


Tibiocalcaneal frame, for external fixation, ofCharcot arthropathy, 596–597, 605

Tibiotalar joint, in arthrodesis and externalfixation techniques, exposure of,529–530

positioning of, 530

Tinel’s sign, with anterior tarsal tunnelsyndrome, 259with diabetic neuropathy, surgical

decompression for, 239, 243–244results review, 249–250

with sural nerve entrapment, 265

Titanium pins, biocompatibility of, 639

TLS angle, in hindfoot deformity correctionplanning, 479

Toe walking. See Idiopathic toe walking.

Topiramate, for chronic pain management, 383

Total ankle arthroplasty (TAA). See alsoReconstruction techniques.anterior ankle subluxation control and,

449–453innovative strategies for, 645–646supramalleolar osteotomy for, 478talectomy for, 778

Total contact casting (TCC), for navicularneuropathy, 153–155, 159–162

Total operative time (TOT), maximizing withregional anesthesia, 349, 351–352

Traction techniques, immediate, for tibial pilonfractures, 460

Tramadol, for chronic pain management,398–399

Transcutaneous electronic nerve stimulation(TENS), for neuropathic pain, 314

Transfibular approach, to external fixation, ofCharcot arthropathy, 597–598, 602–604

Transfibular arthrodesis, of talus, for avascularnecrosis, 769–770

Translation, distal tibia external frame designsfor, 640–642in deformity measurement, 492–500

osteotomy and, 501, 503–504

Transverse intermetatarsal ligament (TIML), inendoscopic neural decompression, for

Morton’s neuroma, 300–301, 303

Transverse metatarsal ligament release, withor without neurolysis, for interdigital

neuroma, 293

Transverse plane motion, in peritalar jointbiomechanics, 664

Transverse tarsal joint, 127–145anatomy of, 128–130

calcaneocuboid joint, 130talonavicular joint, 128–130

biomechanics of, 130–134after arthrodesis, 134–135

orthotic control of, 139–144overview of, 127–128pathologic conditions of, 134–139

arthritis and arthrodesis, 134–135compensatory mechanisms and

secondary changes, 137–139flatfoot deformity, 135–137

Trauma, as interdigital neuroma cause, 289external fixation for, 455–474,

583–594. See also Acute ankletrauma; External fixation.

midfoot presentations, 625–626of navicular, 61–62, 189–191soft tissue, as external fixation indication,

584–587tarsal tunnel syndrome from, 274with navicular injury, 34–35,

56–57to talus, osteonecrosis following,

745–746, 749

‘‘Trauma foot series,’’ of radiographs, 32

Trauma to, soft tissue, tarsal tunnel syndromefrom, 274

treatment of, 279–280with navicular fractures, 34–35,

56–57

Triangular frame, for external fixation, of tibialpilon fractures, 463–464, 466

Tricyclic antidepressants (TCAs), for chronicpain management, 396–397

Triple arthrodesis, for paralytic deformity,tendon transfers versus, 327–328

Tscherne soft tissue injury, grade 0 or I, withtibial pilon fractures, internal fixationtechniques for, 460, 468–469grade II, with malleolar fractures, 471

with tibial pilon fractures, externalfixation techniques for,457–459, 468–469

Tumor(s), of talus, imaging of, 696–698talectomy for, 775, 779

U

Ulceration, with Charcot arthropathy, externalfixation for, 534, 536–537

Ultrasonography, for interdigital neuromadiagnosis, 291


for lower extremity botulinum toxininjection, 340–341

of accessory navicular, 172–173

Uniportal decompression of intermetatarsalnerve (UDIN), for Morton’s neuroma,298, 303

University of California Berkeley Laboratory(UCBL) brace, for transverse tarsal jointcontrol, 141–142

V

Valdecoxib (Bextra), for chronic painmanagement, 378

Valgus deformity(ies), as compensatory, 493,495–497as navicular arthrodesis indication, 74supramalleolar osteotomy for, 479,

484–485tarsal tunnel syndrome from, 275–276

treatment of, 279–280with Muller-Weiss disease, 115, 120

Valleix phenomenon, with tarsal tunnelsyndrome, 276

Valproic acid, for chronic painmanagement, 381

Varicosities, tarsal tunnel syndrome from,274, 280

Varus deformity(ies), as compensatory, 493,495, 497as navicular arthrodesis indication, 74calcaneal, with flatfoot, 138–139heel, tarsal tunnel syndrome from,

274–275treatment of, 279–280

osteotomy rules for correction of,500–505

supramalleolar osteotomy for, 484with Muller-Weiss disease, 115–116,

121–122

Vascular anatomy. See Blood supply.

Vascular factors, of diabetic neuropathy, 227,229–230, 240

Vascularized bone graft, of talus, for avascularnecrosis, 765–768

Vasculitis, in diabetic neuropathy, 233

Vasomotor neuropathy, of tarsal navicular, 148

Vasospasm, post-metatarsal lengthening forbrachymetatarsia, 566–567

Vehicle accidents, talar neck fractures and,724–725

Vein wrap, with revision peripheral neurolysis,for chronic intractable lower extremitypain, 310–311

Venlafaxine (Effexor), for chronic painmanagement, 397–398

Venography, of tarsal tunnel syndrome, 279

Volkman’s contracture, innovative fixationstrategies for, 642, 644–645

W

Wagner classification, of navicularneuropathy, 150

Weight bearing, pain with, as naviculararthrodesis indication, 73–74with ankle fusions, 530–531with external fixation, 433, 436

of Charcot arthropathy, 597,600–601, 607–608

with joint distraction, 443for ankle osteoarthritis, 541,

543–545, 550–551

Weight-bearing, with avascular necrosis, oftalus, 758–759, 771

Weight-bearing imaging, of talonavicular joint,686, 689

Winnie peripheral nerve block, for lowerextremity, 361–362

Wire frame fixation. See also K-wire fixation.for joint distraction, of ankle

osteoarthritis, 544–549, 551–552for soft tissue cavus contractures,

616–618for tibial pilon fractures, with Tscherne

grade II soft tissue injury,462–463, 465

innovations and future directions in, 646

Wound healing, with external fixation, ofmalleolar fractures, 471

of tibial pilon fractures, 468–469soft-tissue reconstruction by flaps

and, 591–593

Wounds, open, distraction osteogenesisconsideration of, 512

X

X-ray stereography, of motion, in talocalcanealjoint, 666–667

in talonavicular joint, 669–670


Date post:	30-Dec-2016
Category:	Documents
Upload:	vanlien
View:	213 times
Download:	0 times

Cumulative Index 2004

Documents