Biomedical subjects
Publications and source records attributed to J Gerbert.
Every effort should be made to prevent the occurrence of postoperative foot infections. However, since they are not always avoidable, every surgeon must be prepared to manage these infections. Early diagnosis is essential in preventing overwhelming sepsis and minimizing disability, and immediate therapy is necessary to resolve the complication and prevent it from recurring.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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For approximately 30 years foot and ankle surgeons have been using a variety of techniques and devices to replace the first metatarsophalangeal joint. During this time there have been a multitude of implant designs and modifications, most attempting to anatomically and functionally replace the natural joint surfaces. The advantages and disadvantages of these many designs and various biomaterials has long been debated in scientific meetings and publications. Surgical technique, implant design, materials, and patient selection remain areas of heated debate and ongoing research. With this in mind, we asked leading foot and ankle surgeons to give their opinions on indications and utilization for joint replacement of the first metatarsophalangeal joint.
A retrospective evaluation of 64 randomly selected patients with 100 nonfixated Austin bunionectomy procedures was performed. A radiographic and a clinical evaluation were performed, including an analysis of preoperative and postoperative angles as well as postoperative complications. This study demonstrates a similar complication rate for nonfixated Austin bunionectomies as compared with previous studies with internal fixation. Removal of the fibular sesamoid was performed in 90% of the cases and did not increase the incidence of hallux varus. The nonfixated Austin bunionectomy is an acceptable alternative to the correction of hallux valgus. If internal fixation is utilized, the most cost-effective device should be used.
The purpose of this paper is to present preliminary findings of an ongoing prospective study of the effectiveness of total digital implants. Forty hinged implants and 22 nonhinged implants have been evaluated to compare the two implants and establish preoperative criteria for their use. Our findings indicate better results for toe purchase and stability with the nonhinged implant and marginally better joint range of movement with the hinged implant. Preoperative dorsal contracture at the metatarsophalangeal joint leads to the most consistent postoperative complications.
In this study the authors have endeavored to define more closely the distinct nature of the collateral and suspensory ligaments of the lesser metatarsophalangeal joints and to propose a mechanism through which the ligaments confer stability to the metatarsal head. The lesser metatarsal neck dorsal V-osteotomy is one surgical procedure that has the potential of disrupting the intracapsular ligaments, depending on the placement of the "V" cut. The angulation of the "V" cut redirects the capital fragment in the sagittal plane while maintaining stability in the transverse and frontal planes. The authors contend that the sagittal stability of the free capital fragment after a V-osteotomy is maintained, as well, by the attachment of the newly defined suspensory ligaments and the collateral ligaments of the metatarsophalangeal joint. Disruption of these ligaments, such as occurs when placing the apex of the V-osteotomy proximally, serves to increase the instability within the metatarsal head, ultimately leading to a potential increase in number of complications.