Midshaft first-ray osteotomies for hallux valgus.

In this article, the authors describe the indications, contraindications, surgical technique and its fixation considerations, postoperative care, results, and potential complications of the offset V and the traditional Z osteotomies. Because of its versatility, inherent stability, minimal first metatarsal shortening, good intermetatarsal reduction, and ease of rigid internal fixation, shaft osteotomies are gaining popularity as procedures for the correction of hallux valgus. Strong and stable internal fixation allows for earlier functional recovery and primary bone healing. Shaft osteotomies can provide predictable and rewarding results for the patient and surgeon for the correction of hallux valgus.

Combined popliteal and saphenous nerve blocks at the knee: an underused alternative to general or spinal anesthesia for foot and ankle surgery.

Peripheral nerve blocks at the ankle have long been used for foot surgery. However, when local foot and ankle blocks are inappropriate or contraindicated, general and spinal anesthesia are the common alternatives. Both have disadvantages and require added equipment and monitors. Combined popliteal and saphenous nerve blocks at the knee can offer a desirable alternative to general and spinal anesthesia for foot and ankle surgery. In addition, popliteal and saphenous nerve blocks provide anesthesia of the entire lower leg, thus permitting a greater variety of procedures to be performed. This article reviews the anatomical considerations, various block techniques, and surgical applications of this useful approach to lower-leg anesthesia.

Complications of intra-articular fractures of the calcaneus.

Most complications of calcaneal fractures are due to the combination of the dynamic nature and the mechanism of the injury itself. Complications are usually secondary to three integral parts of this complex fracture pattern: 1) fracture and depression of the subtalar joint, 2) loss of the height of the calcaneal body with varus rotation, and 3) expansion of the lateral wall of the calcaneus. Other complications occur with less frequency. This article describes the complications and sequelae of old, malunited intra-articular calcaneal fractures in relation to the nature and the components of these unique fractures.