Forefoot Reconstruction

About this book

For a long time, forefoot surgery had many disadvantages including a painful postoperative period and recurrence of deformities. New techniques – notably Scarf, the first metatarsal osteotomy and the Weil osteotomy of the lesser metatarsal – provide a significant improvement in the treatment of static forefoot disorders. The great toe osteotomy has also been greatly improved. Since 1991, the author has introduced these techniques in many countries, while developing and studying the corresponding implants and the postoperative period. He has also developed surgical management techniques that bridge these different osteotomies. More than 1000 surgeons around the world are using these techniques, which are now widely taught. In this second edition of the book the general presentation is clearer and more pleasant and many pictures have been replaced. Several topics are emphasized, notably the great toe proximal phalanx osteotomy, the joint preservative surgery in severe forefoot disorders, including revision after failed bunionectomy and rheumatoid forefoot following the “ms” point for an accurate and effective metatarsal shortening. Lastly, new procedures are exposed, particularly in Claw toe and hammer with the PIP plantar release and the surgery of the middle phalanx and also the Weil osteotomy of the first metatarsal in hallux limitus. A new CD is included which focuses on the pictures, drawings and AVI in 2 or 3D that are now available copyright-free, so as to bring significant help for the surgeon’s scientific works.

Written for:

Orthopedists, surgeons

Keywords:

• Forefoot
• Postopearitve management
• Surgical techniques
• osteotomy

Table of contents

Scarf and Great Toe Osteotomies in the Treatment of Hallux Valgus.- The Weil Lesser Metatarsal Osteotomy.- The BRT Proximal Metatarsal Osteotomy.- Soft Tissue Procedures in Forefoot Surgery.- Gastrocnemius Proximal Release (GPR).- Use of the “20” Memory Staple in Osteotomies of Fusions of the Forefoot.- The Button Temporary Spacer.- The Different Types of Hallux Valgus Deformity.- Hammer and Claw Toe of the Lesser Rays.- Metatarsalgia.- MTP Joint Dislocation of the Lesser Rays.- Impairment of the Lesser MTP Joints (Excluding Rheumatoid Lesion).- Lesser Toes Transverse Deformity.- The Second Ray Pathology.- Some Pathologies of the Fifth Ray.- Lesser Metatarsal Aplasia (Congenital Brachi Metatarsal).- Severe Forefoot Disorders.- Rheumatoid Forefoot.- Some Aspects of Surgery for Hallux Limitus.- Preoperative Management.- Intraoperative Management.- Postoperative Management.- Revision in Forefoot Surgery.- First Principle. The post operative period.- Second Principle. Where to focus the surgery. (Law of the most impaired ray).- Third Principle. The metatarsal parabola.- Fourth Principle. The generous shortening of theMetatarsals.- Fifth Principle. Single ray pathology.- Sixth Principle. Relationships between forefoot, near foot and lower limb.- Seventh Principle. Keep the toes long.- Eighth Principle. Obtain a foot which fits to elegant shoes.- References.- Acknowledgements.- Print version