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rotational osteotomy-success or failure?

Discussion in 'Introductions' started by EMIL1066, Dec 27, 2008.

  1. EMIL1066

    EMIL1066 Member

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    patient has a nucleated ipk lesion under the 2nd metahead.you decide to pinpoint the pathology by using a tiny piece of med i.d. x-ray tape as a marker over the nucleation.a weight-bearing ap x-ray is then taken,being careful that the patient does move the foot forward.the marker is held in position by a clear piece of adhesive tape over the nucleation.the x-ray shows the marker to be over the fibular plantar condyle.you decide to do foot surgery.a dorsal-longitudinal incision is made over the 2nd mpj.the metahead is de-gloved using a mcglamry metatarsal elevator.using a power instrument such as a stryker with a small saggital saw blade,you make a vertical incision at 90 degrees to the metatarsal shaft.the cut is made near the surgical neck and sayre perosteal elevator is used under the meta-shaft to serve as a stop-guideline.the metahead segment is freed of attachments and is rotated 180 degrees,so that the condyles are pointing upwards,dorsally.before closing,the metatarsal segments are internally fixed to achieve stability.question is: will the procedure be a blooming success or a dismal failure or somewhere's between in resolving the ipk problem ?
  2. EMIL1066

    EMIL1066 Member

    error in post -should be careful that the patient does not move the foot forward-sorry for the error emil1066
  3. simonf

    simonf Active Member

    Wouldn't a condylectomy be simpler?
  4. EMIL1066

    EMIL1066 Member

    condylectomy .in my experience. don't work.the old ''crunch'' procedure does,if you removed a small segment of the metatarsal shaft,near the surgical neck.what's your results ?
  5. simonf

    simonf Active Member

    I'd favour condylectomy or schwartz osteotomy, I have done a couple of dorsally based wedge osteotomies for old freibergs to dorsiflex the capital frag' maximally with good results.


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