Master Techniques in Orthopaedic Surgery: The Foot and Ankle

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Master Techniques in Orthopaedic Surgery ®

The Foot and Ankle Fourth Edition

Master Techniques in Orthopaedic Surgery ®

The Foot and Ankle Fourth Edition

Scott Ellis, MD Professor of Orthopaedic Surgery Weill Cornell Medical College Treasurer, American Orthopaedic Foot and Ankle Society Hospital for Special Surgery New York, New York Section Editors A. Holly Johnson, MD Associate Professor Department of Orthopedic Surgery

Cesar de Cesar Netto, MD, PhD Associate Professor Division of Orthopedic Foot and Ankle Surgery Department of Orthopedic Surgery Duke University Durham, North Carolina John Y. Kwon, MD Associate Chief, Foot and Ankle Service Department of Orthopaedics Massachusetts General Hospital Boston, Massachusetts

Weill-Cornell Medical School Hospital for Special Surgery New York, New York

Constantine A. Demetracopoulos, MD Associate Professor of Orthopaedic Surgery Weill Cornell Medical College Associate Attending Foot and Ankle Service Hospital for Special Surgery New York, New York

Mark Drakos, BA, MD Attending Orthopedic Surgeon Foot and Ankle Service, Sports Medicine Hospital for Special Surgery New York, New York

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Contributors

Amiethab Aiyer, MD, FAAOS, FAOA Chief, Foot and Ankle Service

Daniel Baumfeld, MD, PHD Adjunct Professor Federal University of Minas Gerais Foot and Ankle Surgeon Head, Foot and Ankle Clinic

Associate Professor, Department of Orthopaedics Faculty Affiliate, Center for Innovative Leadership Johns Hopkins University Carey Business School Director, Orthopaedic Medical Student Education Director, UME to GME Transition The Johns Hopkins University School of Medicine Baltimore, Maryland Tonya An, MA, MD Clinical Assistant Professor, Orthopedic Surgery Department of Orthopedic Surgery Stanford University Redwood City, California

Felicio Rocho Hospital Belo Horizonte, Brazil Judy Baumhauer, MD, MPH, FAAOS, FAOA Professor of Orthopaedic Surgery Senior Associate Dean for Academic Affairs University of Rochester School of Medicine and Dentistry Director, University of Rochester Clinical Health Informatics Core University of Rochester Medical Center Rochester, New York Clayton C. Bettin, MD, FAAOS Assistant Professor Foot and Ankle Fellowship Director Associate Residency Program Director Department of Orthopaedic Surgery and Biomedical Engineering University of Tennessee–Campbell Clinic Memphis, Tennessee

Albert T. Anastasio, MD Resident Orthopaedic Surgeon Division of Foot and Ankle Department of Orthopaedic Surgery

Duke University Hospital Durham, North Carolina

Michael Aronow, MD, FAAOS, FACS Clinical Professor Department of Orthopaedic Surgery School of Medicine University of Connecticut Hartford Hospital Bone and Joint Institute Orthopedic Associates of Hartford, PC Hartford, Connecticut

Braden Boyer, MD Orthopedic Surgeon Department of Orthopedics Campbell Clinic Memphis, Tennessee

Ahmed Khalil Attia, MD Foot and Ankle Fellow Department of Orthopedic Surgery James W. Brodsky, MD Professor of Surgery, Orthopaedics Texas A&M University HSC College of Medicine Founder, Foot and Ankle Surgery Fellowship Program Baylor University Medical Center Fellowship Director Clinical Professor of Orthopaedic Surgery University of Texas Southwestern Medical School Dallas, Texas Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. University of Pittsburgh Pittsburgh, Pennsylvania Jonathon Backus, MD Assistant Professor Department of Orthopaedic Surgery Washington University in St. Louis St. Louis, Missouri

Contributors

John Wunn Cancian Sr, MD Staff Orthopedic Surgeon Bone and Joint Sports Medicine Institute Naval Medical Center Portsmouth Portsmouth, Virginia Rebecca Cerrato, MD Director, Fellowship Program The Institute for Foot and Ankle Reconstruction Mercy Medical Center Baltimore, Maryland Elizabeth A. Cody, MD Assistant Professor of Orthopedic Surgery Weill Cornell Medical College Assistant Attending Orthopedic Surgeon Hospital for Special Surgery and New York Presbyterian Hospital New York, New York Stamford Hospital Stamford, Connecticut J. Chris Coetzee, MD Orthopedic Foot and Ankle Surgeon Past President, American Orthopedic Foot and Ankle Society Twin Cities Orthopedics Eagan, Minnesota Matthew S. Conti, MD Assistant Attending Orthopedic Surgeon Hospital for Special Surgery Assistant Professor of Orthopedic Surgery Weill Cornell Medical College New York, New York Miki Dalmau-Pastor, PhD Associate Professor Constantine A. Demetracopoulos, MD Associate Professor of Orthopaedic Surgery Weill Cornell Medical College Associate Attending Foot and Ankle Service Hospital for Special Surgery New York, New York W. Hodges Davis, MD Senior Partner, OrthoCarolina Foot & Ankle Institute Foot and Ankle Section Chief Atrium Health Charlotte, North Carolina James S. Davitt, MD, FAAOS Orthopedic and Fracture Specialists, PC Portland, Oregon Pathology and Experimental Therapeutics Human Anatomy and Embryology Unit University of Barcelona Barcelona, Spain

Paul Dayton, DPM, MS Foot and Ankle Surgeon Foot and Ankle Center of Iowa Ankeny, Iowa

Kepler Alencar Mendes de Carvalho, MD Visiting Associate Foot and Ankle Surgery Orthopedic Functional Imaging Research Laboratory Department of Orthopedics and Rehabilitation Carver College of Medicine University of Iowa Iowa City, Iowa

William T. DeCarbo, DPM Foot and Ankle Surgeon Department of Surgery Greater Pittsburgh Foot and Ankle Center Wexford, Pennsylvania

Jonathan Deland, MD Attending Surgeon Orthopaedic Surgery Hospital for Special Surgery New York, New York

Mark Drakos, BA, MD Attending Orthopedic Surgeon Foot and Ankle Service, Sports Medicine Hospital for Special Surgery New York, New York

Mark E. Easley, MD Associate Professor

Chief, Division of Foot and Ankle Department of Orthopaedic Surgery Duke University Medical Center Durham, North Carolina

M. Pierce Ebaugh, DO Attending Orthopedic Surgeon Jewett Orthopedic Institute at Orlando Health Orlando, Florida Benjamin Ebben, MD Bellin Health Titletown Sports Medicine and Orthopedics Green Bay, Wisconsin

J. Kent Ellington, MD, MS, FAAOS OrthoCarolina Medical Director of the Foot and Ankle Institute Assistant Professor of Orthopaedic Surgery Atrium Health Adjunct Assistant Professor of Biology UNC Charlotte Co-Founder, Pressio Spine, Inc. Charlotte, North Carolina Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.

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Contributors

Stephanie S. Gardner, MD Foot and Ankle Clinical Fellow Department of Orthopedics Campbell Clinic Memphis, Tennessee Arianna L. Gianakos, DO Assistant Professor of Orthopaedic Surgery Foot and Ankle Division Department of Orthopaedic Surgery Yale Orthopaedics and Rehabilitation New Haven, Connecticut Christopher E. Gross, MD Professor of Orthopaedic Surgery Department of Orthopaedic Surgery Medical University of South Carolina Director, Foot and Ankle Surgery Fellowship Director Charleston, South Carolina Matteo Guelfi, MD, PhD Consultant Foot and Ankle Unit Casa di Cura Villa Montallegro Genoa, Italy Ajay N. Gurbani, MD Assistant Professor Department of Orthopaedic Surgery David Geffen School of Medicine at UCLA Los Angeles, California Gregory P. Guyton, MD Division Chief of Foot and Ankle Surgery, and the Fellowship Director Department of Orthopaedic Surgery MedStar Union Memorial Hospital Baltimore, Maryland Daniel J. Hatch, DPM Director, Foot and Ankle Surgery–Podiatry Residency Department of Surgery North Colorado Medical Center Greenly, Colorado Jensen K. Henry, MD Assistant Attending Surgeon Orthopaedic Foot and Ankle Surgery Hospital for Special Surgery New York, New York McCalus V. Hogan, MD, MBA, FAAOS, FAOA Professor and Chair Chief

Scott Ellis, MD Professor of Orthopaedic Surgery Weill Cornell Medical College Treasurer, American Orthopaedic Foot and Ankle Society Hospital for Special Surgery New York, New York

Norman Espinosa, MD Head of FussInstitut Zürich AG Institute for Foot and Ankle Reconstruction Zurich, Switzerland

Richard D. Ferkel, MD Assistant Clinic Professor

Department of Orthopedic Surgery University of California, Los Angeles Los Angeles, California Program Director, Sports Medicine Fellowship Southern California Orthopedic Institute Van Nuys, California

Brian M. Fisher, MD Assistant Professor Department of Orthopaedic Surgery School of Medicine Greenville University of South Carolina Prisma Health Blue Ridge Orthopedics Easley, South Carolina

Amanda N. Fletcher, MD, MSc Orthopaedic Surgeon, Foot and Ankle Fellowship Trained Orthopaedic Surgery, Foot and Ankle Institute of Foot and Ankle Reconstruction

Mercy Medical Center Baltimore, Maryland

Austin T. Fragomen, MD Professor of Clinical Orthopaedic Surgery Weill Medical College of Cornell University Director, Limb Salvage and Amputation Reconstruction Center Fellowship Director, Limb Salvage and Amputation Reconstruction Center Hospital for Special Surgery New York, New York

Daniel Fuchs, MD Assistant Professor Department of Orthopaedic Surgery Rothman Orthopaedics at Jefferson University Philadelphia, Pennsylvania Oliver J. Gagne, MDCM, MSc, FRCSC Clinical Instructor University of British Columbia Foot and Ankle Orthopedic Surgeon Saint-Paul’s Hospital Vancouver, British Columbia

Division of Foot and Ankle Surgery Department of Orthopaedic Surgery

University of Pittsburgh Pittsburgh, Pennsylvania

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Contributors

James R. Holmes, MD Associate Professor Chief of Foot and Ankle Service Department of Orthopaedic Surgery

Kimberly Koury, MD Department of Orthopedic Surgery Englewood Hospital Englewood, New Jersey John Y. Kwon, MD Associate Chief, Foot and Ankle Service Department of Orthopaedics Massachusetts General Hospital Boston, Massachusetts L. Daniel Latt, MD, PhD Associate Professor Orthopaedic Surgery and Biomedical Engineering Director of Clinical Research Department of Orthopaedic Surgery University of Arizona Tucson, Arizona Woo-Chun Lee, MD, PhD Director, Fellowship Training Program Seoul Foot and Ankle Center Department of Orthopaedic Surgery Dubalo Hospital Seoul, South Korea Shuyuan Li, MD, PhD International Program Director Steps2Walk, Inc. Denver, Colorado Stephanie Maestre, MD Foot and Ankle Orthopaedic Surgeon Department of Orthopaedic Surgery and Sports Medicine Excela Health System Greensburg, Pennsylvania Nacime Salomao Barbachan Mansur, MD, PhD Visiting Associate Orthopedic Functional Imaging Research Laboratory Department of Orthopedics and Rehabilitation Carver College of Medicine University of Iowa Iowa City, Iowa Foot and Ankle Surgeon Department of Orthopedics and Traumatology Paulista School of Medicine Federal University of Sao Paulo Sao Paulo, Brazil Jody P. McAleer, DPM, FACFAS

University of Michigan Ann Arbor, Michigan Kenneth J. Hunt, MD Associate Professor and Chief Foot and Ankle Surgery Vice Chair, Quality, Patient Safety and Outcomes Medical Director UCHealth Foot and Ankle Center Department of Orthopaedic Surgery University of Colorado School of Medicine Denver, Colorado Kelly K. Hynes, MScBMI, MD, FRCSC Associate Professor Department of Orthopedic Surgery The University of Chicago Chicago, Illinois Eitan M. Ingall, MD Fellow OrthoCarolina Foot & Ankle Institute

Charlotte, North Carolina A. Holly Johnson, MD Associate Professor Department of Orthopedic Surgery

Weill-Cornell Medical School Hospital for Special Surgery New York, New York Anish R. Kadakia, MD Professor of Orthopaedic Surgery Northwestern Center for Comprehensive Orthopaedic and Spine Care

Fellowship Director, Foot and Ankle Department of Orthopaedic Surgery Northwestern Memorial Hospital Primary Specialty Foot and Ankle Surgery Chicago, Illinois Sarang P. Kasture, FRCS (T&O) Consultant Foot and Ankle Surgeon Department of Trauma and Orthopaedics University Hospitals of Derby and Burton Burton upon Trent, United Kingdom Jaeyoung Kim, MD Research Fellow Foot and Ankle Service Orthopaedic Surgery Hospital for Special Surgery New York, New York Georg C. Klammer, MD Deputy Head of FussInstitut Zürich AG Institute for Foot and Ankle Reconstruction Zurich, Switzerland

Foot and Ankle Surgeon Department of Podiatry Jefferson City Medical Group Jefferson City, Missouri Jeremy J. McCormick, MD Associate Professor of Orthopaedic Surgery Chief, Foot and Ankle Surgery Director, Foot and Ankle Fellowship Program Washington University in St. Louis St. Louis, Missouri Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.

Contributors

Martin O’Malley, MD Orthopaedic Surgeon

William C. McGarvey, MD Professor and Vice Chairman Department of Orthopedic Surgery University of Texas Health Science Center–Houston Residency Program Director Department of Orthopedic Surgery Fellowship Program Director–Orthopedic Foot and Ankle Fellowship University of Texas Health Science Center–Houston Past President, American Orthopedic Foot and Ankle Society Houston, Texas Max P. Michalski, MD, MSc Assistant Professor Department of Orthopaedic Surgery Cedars-Sinai Medical Center Los Angeles, California Andrew Molloy, MBChB, MRCS, FRCS Tr&Orth Consultant Orthopaedic Surgeon Spire Liverpool Hospital Consultant Orthopaedic Surgeon Liverpool University Hospitals Foundation Trust Honorary Clinical Senior Lecturer Department of Musculoskeletal Biology and Ageing University of Liverpool Liverpool, Merseyside, United Kingdom Drew Murphy, MD Professor Department of Orthopedic Surgery University of Tennessee–Campbell Clinic Memphis, Tennessee

Foot and Ankle Sports Medicine Hospital for Special Surgery Associate Professor of Orthopaedic Surgery Weill Cornell Medical College New York, New York Brian Joseph Page, MD Clinical Fellow Limb Lengthening and Complex Reconstruction Service Hospital for Special Surgery New York, New York Selene G. Parekh, MBA, MD Professor of Orthopaedic Surgery Rothman Orthopaedic Institute Sidney Kimmel College of Medicine at Thomas Jefferson University Philadelphia, Pennsylvania

Vandan D. Patel, MD Foot and Ankle Fellow Institute for Foot and Ankle Reconstruction

Mercy Medical Center Baltimore, Maryland

David Pedowitz, MS, MD Chief, Division of Foot and Ankle Professor of Orthopaedic Surgery Director, Foot and Ankle Fellowship Sidney Kimmel Medical College Thomas Jefferson University Rothman Orthopedics Philadelphia, Pennsylvania Alexander B. Peterson, MD Assistant Professor of Clinical Orthopedic Surgery Department of Orthopedics Keck School of Medicine of USC Los Angeles, California Phinit Phisitkul, MD, MHA, FAAOS Orthopedic Surgeon Center for Neurosciences, Orthopaedics, and Spine Dakota Dunes, South Dakota Medical Director

Mark S. Myerson, MD Professor of Orthopedics University of Colorado President and Founder

Steps2Walk, Inc. Denver, Colorado Justin Orr, MD Associate Clinical Professor Department of Orthopaedic Surgery Texas Tech University of Health Sciences El Paso, Texas Caio Nery, MD, PhD Associate Professor Department of Orthopedics and Traumatology Foot and Ankle Clinic Escola Paulista de Medicina Federal University of São Paulo São Paulo, Brazil Cesar de Cesar Netto, MD, PhD Associate Professor Division of Orthopedic Foot and Ankle Surgery Department of Orthopedic Surgery Duke University Durham, North Carolina

Riverview Surgical Center South Sioux City, Nebraska Adjunct Assistant Professor

College of Allied Health Professions University of Nebraska Medical Center Omaha, Nebraska

Contributors

Fernando Raduan, MD Foot and Ankle Division Massachusetts General Hospital

Lew C. Schon, MD, FACS, FAAOS Director of Orthopaedic Innovation Institute of Foot and Ankle Reconstruction Mercy Medical Center Professor of Orthopaedics New York University Langone Professor of Orthopaedics & BME Johns Hopkins School of Medicine Associate Professor of Orthopaedics Georgetown School of Medicine Adjunct Professor and Fischell Literati Faculty Department of Bioengineering University of Maryland Orthopaedics Baltimore, Maryland

Harvard Medical School Boston, Massachusetts

John M. Rawlings, MD Orthopedic Sports Medicine Surgeon Western Orthopedics & Sports Medicine Community Hospital Grand Junction, Colorado Carson Rider, MD Instructor of Orthopaedic Surgery University of Tennessee Health Science Center Campbell Clinic Memphis, Tennessee Matthew M. Roberts, MD Chief, Foot and Ankle Service Hospital for Special Surgery Associate Professor of Clinical Orthopedic Surgery Weill Medical College of Cornell University New York, New York

Daniel J. Scott, MD, MBA Associate Professor

Department of Orthopaedic Surgery Medical University of South Carolina Charleston, South Carolina

W. Bret Smith, DO, MSc Director of Foot and Ankle Center Mercy Orthopedic Associates Mercy Hospital Durango, Colorado

Andrew J. Rosenbaum, MD Vice-Chairman, Research Associate Professor Department of Orthopaedic Surgery Albany Medical College Albany, New York Niall Smyth, MD Orthopaedic Surgeon Department of Orthopaedic Surgery Cleveland Clinic Florida Weston, Florida Nelson F. SooHoo, MD Associate Dean for Graduate Medical Education Professor of Orthopaedic Surgery UCLA School of Medicine Los Angeles, California Andrew P. Thome Jr, MD Assistant Professor Foot and Ankle Division Department of Orthopaedic Surgery Washington University School of Medicine St. Louis, Missouri David B. Thordarson, MD Professor, Department of Orthopedic Surgery Director of Orthopedic Research Cedars-Sinai Medical Center Los Angeles, California Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. Robert D. Santrock, MD Clinical Associate Professor Orthopaedics Duke University Durham, North Carolina Ian Savage-Elliott, MD Fellow Department of Orthopedics Washington University in St. Louis St. Louis, Missouri Kevin A. Schafer, MD Fellow Department of Orthopedic Surgery Mercy Medical Center Baltimore, Maryland

Contributors

David M. Walton, MD Assistant Professor

Justin Tsai, MD Orthopaedic Surgeon Department of Orthopaedic Surgery Rothman Orthopaedic Institute Philadelphia, Pennsylvania Jordi Vega, MD Associate Professor Laboratory of Arthroscopic and Surgical Anatomy Human Anatomy Unit Department of Pathology and Experimental Therapeutics University of Barcelona Orthopaedic Surgeon Foot and Ankle Unit iMove Traumatology–Clinica Tres Torres Barcelona, Spain Emilio Wagner, MD Associate Professor Department of Foot and Ankle Surgery Clinica Alemana de Santiago—Universidad del Desarrol Universidad del Desarrollo Santiago, Chile Pablo Wagner, MD, MPH Associate Professor Clinica Alemana de Santiago—Universidad del Desarrollo Associate Professor Hospital Militar de Santiago—Universidad de los Andes Foot and Ankle Staff Department of Orthopedic Surgery

Department of Orthopaedic Surgery University of Michigan Medical Center Ann Arbor, Michigan Alastair S. E. Younger, MB, ChB, MSc, ChM, FRCSC Orthopaedic Foot and Ankle Surgeon Professor Head of Distal Extremities Department of Orthopaedics University of British Columbia Director of Foot and Ankle Research St. Paul’s Hospital Past President British Columbia Orthopaedic Association Partner Footbridge Centre for Integrated Orthopaedic Care Inc.

Surgeon Scientist, CHEOS Department of Orthopaedics St. Paul’s Hospital Vancouver, British Columbia, Canada John Z. Zhao, MD Foot and Ankle Clinical Fellow Department of Orthopedics Campbell Clinic Memphis, Tennessee

Clinica Alemana de Santiago Hospital Militar de Santiago Santiago, Chile

Series Preface

S ince its inception 1994, the Master Techniques in Orthopaedic Surgery series has become the gold standard for both physicians in training and experienced surgeons. Its exceptional success may be traced to the leadership of the original series editor, Roby Thompson, whose clarity of thought and focused vision sought “to provide direct, detailed access to techniques preferred by orthopaedic surgeons who are recognized by their colleagues as ‘masters’ in their specialty,” as he stated in his series preface. It is personally very rewarding to hear testimonials from both residents and practicing surgeons on the value of these volumes to their training and practice. A key element of the success of the series is its format. Of note, this format was inspired by Dr. Kenneth Johnson, a foot and ankle orthopaedic surgeon from the Mayo Clinic. Ken was a personal friend of mine. This fourth edition of Master Techniques series is, in my opinion, a testament to his vision and individuality. He wanted to prepare a book about the way he did foot and ankle surgery. He was not interested in presenting the world’s experience, but rather, “here’s how I do it.” The effectiveness of this format is reflected by the fact that it is now being replicated by other publishers. Among other strengths, an essential feature of the Master Techniques series is the standardized presentation and illustration of information with tips and pearls shared by experts with years of experience. Abundant color photographs and drawings guide the reader through the procedures step-by-step. The second key to the success of the Master Techniques series rests in the reputation and experience of our volume editors. The editors are truly dedicated and recognized “masters” with a commitment to share their rich experience through these texts. We are proud of the progress made in formulating the fourth edition volumes and are particularly pleased with the expanded context of this series. Since its inception, new volumes have been added in an effort to remain relevant and to cover topics that are exciting and useful to a broad cross section of our profession. While we have expanded the Master Techniques topics and editors with additional titles, we have remained true to the now classic format. The first of the new volumes was Relevant Surgical Exposures , edited with my son, Matthew. Additional volumes include Essential Procedures in Pediatrics, Soft Tissue Reconstruction, Advanced Techniques in Joint Reconstruction, and Essential Procedures in Sports Medicine . The full library consists of useful and relevant titles covering the full spectrum of our profession. I am pleased to be involved as the series editor, as I feel strongly about the value of the series in educating the surgeon in the full array of expert surgical procedures. The true worth of this endeavor will continue to be mea sured by the ever-increasing success and critical acceptance of the series. I remain indebted to Dr. Thompson for his inaugural leadership as well as to the Master Techniques volume editors and numerous contributors who have been true to the series style and vision. The words of William Mayo are especially relevant to characterize the ultimate goal of this endeavor. “The best interest of the patient is the only interest to be considered.” We are confident that the information in the expanded Master Techniques offers the surgeon an opportunity to realize the patient-centric view of our surgical practice.

Bernard F. Morrey, MD Series Editor

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Preface

I still remember reading the second edition of Master Techniques in Foot and Ankle Surgery as a resident and fellow as I prepared for my cases on the foot and ankle service each day. I found myself ready each morning to carry out surgeries that my attendings scheduled, no matter what the calendar might have held. The vast array of types and techniques of surgery, described by leaders in the field I would later come to know, drew me to my ultimate decision to specialize in this exciting field. When Dr. Morrey and Dr. Kitaoka asked me edit the fourth edition of Master Techniques in Orthopaedic Surgery , I felt honored and motivated to contribute, but knew I would need help. After all, it was their insight and hard work that brought the book to its current level. However, much has changed as the field rapidly evolves. I have leveraged expertise by colleagues from all over the world to capitalize on the latest advances in our field. While cutting edge research and data drives much of our decision-making in surgery, having a trusted col league take you through a case presents the most valuable opportunity to learn and improve patient outcomes that I know. I have chosen the subsection editors carefully for this series given their international reputation, research, and expertise: A. Holly Johnson (forefoot and MIS), Mark Drakos (sports and Achilles), Constantine A. Demetracopoulos (total ankle), Cesar de Cesar Netto (flatfoot), and John Kwon (trauma and neuromuscular disorder) have provided countless hours to create a book that will serve both as a teaching manual and reference for both trainees and experienced surgeons alike. The vast majority of chapters present new material and, in particular, even new techniques not performed at the time the last edition came out over 10 years ago. This holds true for each subsection, but especially for total ankle and minimally invasive approaches. Chapters on deformity reconstruction, bunion, and tendon/ligament reconstruction also reflect the latest advances. I am confident that in another 10 years we will all read a differ ent book as well. I have tried to balance opinions, strategies, and approaches across all techniques. For example, all current total ankle replacement prostheses have their own chapter, each highlighting positive design features along with tips and pearls from the experts that use them regularly. The same holds true for traditional versus more minimally invasive approaches. Because nothing comes easy in foot and ankle surgery, topics run from the simple to most complex. I hope that you learn as much as I have when reading these techniques, written by the masters in our field. I thank the authors for their tireless efforts despite running busy practices, spending time away from their families, and competing with other academic duties such as teaching and research. I encourage our colleagues in foot and ankle surgery to use these to update their knowledge and as a reference for the cases you perform. I am confident that those reading the chapters will likely be the next ones writing them in the coming years.

Scott Ellis, MD

Contents

Contributors v Series Preface xiii Preface xv

PART 1 Forefoot/Bunion 1 Section Editor: A. Holly Johnson

CHAPTER 1

Lapidus With Akin 1 Matthew S. Conti and W. Hodges Davis

CHAPTER 2

Scarf First Metatarsal Osteotomy 19 Andrew Molloy and Sarang P. Kasture

CHAPTER 3 Minimally Invasive Surgical (MIS) Bunionectomy 31 Tonya An and A. Holly Johnson

CHAPTER 4 Correction of Hallux Valgus With and Without Metatarsus Adductus 53 Mark E. Easley, Paul Dayton, William T. DeCarbo, Daniel J. Hatch, Jody P. McAleer, W. Bret Smith, and Robert D. Santrock

CHAPTER 5 Proximal Rotational Metatarsal Osteotomy (PROMO) 101 Emilio Wagner and Pablo Wagner

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Contents

PART 2 Forefoot/Hallux Rigidus 113 Section Editor: A. Holly Johnson

CHAPTER 6

Cheilectomy/Moberg 113 Kimberly Koury and Judy Baumhauer

CHAPTER 7 Minimally Invasive Surgery (MIS) Cheilectomy With Moberg Osteotomy 129 Vandan D. Patel and Rebecca Cerrato

PART 3 Total Ankle Replacement 143 Section Editor: Constantine A. Demetracopoulos

CHAPTER 8

Salto Talaris Total Ankle Replacement 143 James S. Davitt

CHAPTER 9 Paragon 28 APEX 3D Fixed-Bearing Total Ankle Replacement 163 Christopher E. Gross and Daniel J. Scott

CHAPTER 10

Infinity Total Ankle Replacement 179 Brian M. Fisher and Jeremy J. McCormick

CHAPTER 11

Lateral Approach Total Ankle Arthroplasty 199 Kevin A. Schafer and Lew C. Schon

CHAPTER 12 The Stryker INBONE II Total Ankle Arthroplasty System 219 M. Pierce Ebaugh and William C. McGarvey CHAPTER 13 Exactech Vantage Fixed-Bearing Total Ankle Replacement 233 Jensen K. Henry and Constantine A. Demetracopoulos

CHAPTER 14

Cadence Total Ankle Replacement 251 Justin Tsai, Daniel Fuchs, and David Pedowitz

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Contents

PART 4 Sports 275 Section Editor: Mark Drakos

CHAPTER 16

Hamstring Peroneals 275 Mark Drakos

CHAPTER 17 Lateral Ankle Ligament Repair and Reconstruction 285 L. Daniel Latt CHAPTER 18 Débridement, Repair, and Regeneration of Osteochondral Lesions of the Talus 299 John M. Rawlings and Richard D. Ferkel CHAPTER 19 Osteochondral Autologous Transfer Systems (OATS) for the Treatment of Talar Osteochondral Lesions: The OATS Procedure 317 Ahmed Khalil Attia and McCalus V. Hogan CHAPTER 20 Open Reduction and Internal Fixation Fifth Metatarsal 337 Kenneth J. Hunt and Benjamin Ebben CHAPTER 21 Open Reduction and Internal Fixation of Navicular Stress Fractures 349 Andrew J. Rosenbaum and Martin O’Malley

CHAPTER 22

Os Trigonum Resection 359 J. Chris Coetzee

PART 5 Achilles 367 Section Editor: Mark Drakos

CHAPTER 23 Graft Reconstruction for Treatment of Chronic Achilles Tendon Ruptures 367 Carson Rider, Drew Murphy, Stephanie S. Gardner, and John Z. Zhao

Contents

CHAPTER 25 Endoscopic Treatment of Insertional Achilles Deformity 389 Jordi Vega, Matteo Guelfi, and Miki Dalmau-Pastor CHAPTER 26 Minimally Invasive (MIS) Repair of Achilles Tendon Ruptures 403 Ian Savage-Elliott and Jonathon Backus

PART 6 Flatfoot 417 Section Editor: Cesar de Cesar Netto

CHAPTER 27 Lateral Column Lengthening and Medial Displacement Calcaneal Osteotomies for Progressive Collapsing Foot Deformity 417 Michael Aronow CHAPTER 28 First Ray Procedures in Progressive Collapsing Foot Deformity: Cotton, Lapidus, and Lapicotton 429 Nacime Salomao Barbachan Mansur, Kepler Alencar Mendes de Carvalho, and Cesar de Cesar Netto CHAPTER 29 Subtalar Fusion for Progressive Collapsing Foot Deformity 453 Tonya An, Scott Ellis, and Matthew M. Roberts

CHAPTER 30 Minimally Invasive Osteotomies of the Calcaneus 471 Gregory P. Guyton

CHAPTER 31

Spring Ligament Reconstruction 481 Jaeyoung Kim and Jonathan Deland

CHAPTER 32

Double/Triple Arthrodesis 491 James W. Brodsky and Andrew P. Thome Jr

PART 7 Ankle Osteoarthritis 513 Section Editor: Constantine A. Demetracopoulos

CHAPTER 33

Ankle Distraction Arthroplasty 513 Austin T. Fragomen and Brian Joseph Page

CHAPTER 34 Open Ankle Arthrodesis Utilizing Anterior Plating 527 David M. Walton and James R. Holmes

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Contents

CHAPTER 35

Ankle Fusion With External Fixation 539 Justin Orr

CHAPTER 36

Arthroscopic Ankle Arthrodesis 567 Oliver J. Gagne and Alastair S. E. Younger

CHAPTER 37

Supramalleolar Osteotomy 577 Jaeyoung Kim and Woo-Chun Lee

CHAPTER 38

Tibiotalocalcaneal Fusion 595 Braden Boyer, John Wunn Cancian, and Clayton C. Bettin

CHAPTER 39

Total Talus Replacement 615 Albert T. Anastasio, Amanda N. Fletcher, and Selene G. Parekh

PART 8 Forefoot/Lesser Toes 629 Section Editor: A. Holly Johnson

CHAPTER 40

Crossover Toe Correction 629 Phinit Phisitkul

CHAPTER 41 Lesser Toes Metatarsophalangeal Plantar Plate Tears: Dorsal Direct Repair in Combination With Weil Osteotomy 647 Caio Nery and Daniel Baumfeld

PART 9 Trauma 663 Section Editor: John Y. Kwon

CHAPTER 42

Ankle Fracture Late Syndesmosis Repair 663 Fernando Raduan and John Y. Kwon

CHAPTER 43 Arthroscopic-Assisted Open Reduction and Internal Fixation Ankle 677 Arianna L. Gianakos, Stephanie Maestre, Niall Smyth, and Amiethab Aiyer CHAPTER 44 Minimally Invasive Open Reduction and Internal Fixation Calcaneus 689 Alexander B. Peterson, Max P. Michalski, and David B. Thordarson

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Contents

PART 10 Neuromuscular 703 Section Editor: John Y. Kwon

CHAPTER 45

Posterior Tibial Tendon Transfer 703 Ajay N. Gurbani and Nelson F. SooHoo

CHAPTER 46 The Malerba Osteotomy and First Metatarsal Dorsiflexion Osteotomy 711 Elizabeth A. Cody

CHAPTER 47 Reconstruction in Charcot-Marie-Tooth Disease 719 Norman Espinosa, Anish R. Kadakia, and Georg C. Klammer CHAPTER 48 Salvage of Over/Undercorrected Neuromuscular Foot 739 Shuyuan Li and Mark S. Myerson

Index 765

Haglund Deformity With Flexor Hallucis Longus Tendon Transfer

Kelly K. Hynes

INTRODUCTION Insertional tendinopathy makes up about 30% of all causes of Achilles tendon pain. 1 Haglund defor mity is a prominent posterior superior border of the calcaneus and is considered part of the spectrum of calcific insertional tendinopathy. Patients present with painful swelling in the posterior aspect of the heel and ensuing problems with rubbing and discomfort from the posterior part of the shoe occurs. True Haglund syndrome is caused by a mechanically induced irritation of the Achilles ten don and associated retrocalcaneal bursa. Patients may present at a younger age with calcific inser tional tendinopathy, sometimes bilateral, which should alert the clinician to the possibility of a more generalized inflammatory arthropathy. The terms “tendinopathy” and “tendinosis” are now widely accepted in the literature as histopath ologic studies of débrided tendon have shown a lack of inflammatory response; mucoid degenera tion and collagen disorganization, fatty infiltration, and increased thickness are the more common findings. 2 Conservative treatments include reducing pressure on the affected area with soft heel counters, open back shoes, and heel lifts. Night splints may be used in the setting of an equinus contracture; however, their efficacy has not been shown in the literature. 3 Repetitive weight-bearing activities should be limited and eccentric Achilles stretching with formal physical therapy is encouraged. We do not advocate the use of steroid injections around the Achilles tendon due to concerns regarding rupture. Studies of extracorporeal shockwave therapy have revealed varying results, but some ben efit has been shown when combined with a physical therapy program. 4 The majority, around 80%, of patients can be reassured regarding the success of nonoperative treatments. 5 Surgical treatment of insertional Achilles tendinopathy in the form of Achilles tendon débride ment, tendon detachment, Haglund excision, and tendon reattachment with or without flexor hallu cis longus (FHL) tendon transfer augmentation has been the mainstay of operative treatment of this condition with generally good outcomes. An FHL tendon transfer may also be used in other presen tations of Achilles tendon deficiency such as a delayed presentation of an Achilles tendon rupture. INDICATIONS AND CONTRAINDICATIONS The decision to operate will ultimately depend on the duration of symptoms, the level of discomfort, and the disability that this causes.

●● Stiffness/pain especially after a period of rest ●● Disability limiting daily or recreational activities ●● Failure of conservative treatments (greater than 3 to 6 months) ●● Difficulty with comfort in shoe wear ●● Degenerative rupture of the Achilles tendon

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Surgery should be avoided in the presence of ●● Skin breakdown

●● Active or chronic infection ●● Poorly controlled diabetes ●● Peripheral vascular disease ●● Peripheral neuropathy ●● Tobacco use

PREOPERATIVE PLANNING Lateral radiographs of the heel (Fig. 24.1) are useful in quantifying the degree of calcification within the tendon insertion, which can help to predict the degree of degeneration present, the likelihood of disrupting the Achilles insertion, and, therefore, the need for surgical augmentation and postopera tive protocol implications. In patients with insertional Achilles tendinopathy, 65% to 80% will have an enthesophyte seen on the lateral radiograph while in people without foot pain, 25% to 35% will have an enthesophyte present. 6 Retrocalcaneal bursitis can be seen as a loss of the normal soft tissue shadowing in the space anterior to the Achilles tendon (Kager triangle) and in long-standing cases may lead to erosion of the cortex of the posterosuperior prominence. Various measurements have been described in attempting to quantify the size of the Haglund deformity. In some cases, magnetic resonance imaging (MRI) assessment of the Achilles insertion and Haglund deformity may be helpful in preoperative planning. Assessment of the thickness of the tendon and intrasubstance degeneration has been found to have implications for the success of nonsurgical man agement. One study found that patients who have greater than 8-mm tendon thickness required sur gical treatment 70% to 90% of the time (Fig. 24.2). 7 The specific indications for MRI in insertional Achilles tendinopathy are not well established. In the author’s experience, patients who have a large Haglund deformity radiographically and clinically are not imaged with MRI preoperatively as an open approach with more significant detachment will be required to sufficiently access the entire area of pathology; therefore, no change in surgical management would occur based on MRI findings. In patients with less clinically apparent disease or where the pathology may be in question, an MRI may be helpful both to confirm the diagnosis as well as to assess the extent of the tendinopathy. In a small number of cases with primarily ventral changes of the tendon, endoscopic calcaneoplasty and tendon débridement may be an option for treatment. This option is also more likely to be considered in patients for who a prolonged weight-bearing time and recovery may not be well tolerated. There have been descriptions of some alternative procedures to standard open débridement, detach ment, Haglund excision, and reattachment, which will not be explored in detail here. Consideration should be made based on physical exam if an adjunctive procedure to improve dorsiflexion range of motion, such as a gastrocnemius recession, is indicated. Minimally invasive techniques for Haglund

FIGURE 24.1 Lateral view of heel with a calcaneal prominence. The retrocalcaneal bursa is just posterior to the calcaneus and anterior to tendon attachment.

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24 Haglund Deformity With Flexor Hallucis Longus Tendon Transfer

deformity débridement have been described but thus far have been limited from widespread use for cases when significant tendon detachment may be necessary due to limitations of percutaneous reat tachment and/or FHL transfer. Minimally invasive techniques are rapidly evolving, and there may be accepted such alternatives to the presently described technique in the not too distant future. SURGICAL TECHNIQUE Technique 1: Haglund Excision Through Tendon-Splitting Approach ●● The patient is placed in a prone position, with the foot elevated with a bolster or blankets under the leg (Fig. 24.3A). ●● The approach is through a posterior midline incision (Fig. 24.3B). Care should be taken to avoid injury to the sural nerve, which may be seen lying along the tendon’s lateral border in the subcu taneous tissue. ●● Alternatives to the posterior midline approach have been described, although they are less com monly used. J-Shaped, transverse, medial, and lateral approached have all been reported. ●● A tendon-splitting approach (Fig. 24.4A) is used, and the tendon carefully dissected to expose degenerative tissue, intrasubstance tears, and intrasubstance calcifications (Fig. 24.4B). A primary goal of this procedure is to perform a thorough débridement of the degenerative areas of tendon and calcifications. This tendon-splitting approach provides excellent access to FHL should aug mentation be required. ●● Varying degrees of tendon detachment may be required in order to gain sufficient exposure of the degenerative areas of tendon insertion and Haglund deformity. By some reports, 70% to 80% tendon detachment is usually needed to gain sufficient exposure. 8 Where possible, leaving the most medial and lateral extents of the tendon attachment intact is very helpful to maintain resting tendon tension and is feasible in all but the most severe cases. ●● Abnormal tendon is excised (Fig. 24.5A). While it may be challenging to distinguish normal from abnormal tendon, uniform tissue that has lost the natural tendon striations and is much thicker in texture than normal tendon should be excised. One way of describing the abnormal tendon has been like the texture of “crab meat,” which is meant to describe disorganization of the fibers and FIGURE 24.2 A. Axial cut of magnetic resonance imaging (MRI) showing intrasubstance degeneration. B. Sagittal MRI image of Achilles tendon insertion showing thickening of the tendon at the insertion and large calcaneal prominence.

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FIGURE 24.3 A. Prone positioning with blankets under the leg. B. Incision marked for posterior approach.

FIGURE 24.4 A. The Achilles tendon is split in the midline. B. The Achilles is dissected sharply to reveal the intratendinous tearing and degeneration.

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24 Haglund Deformity With Flexor Hallucis Longus Tendon Transfer

may provide some guidance for the surgeon in débridement. If it is still difficult to determine normal from abnormal tissue, the primary goal of the procedure is to debulk the tendon to a more normal thickness. Inflamed bursa and scarred or fibrosed fat are removed from above the retroc alcaneal space to define the Haglund deformity (Fig. 24.5B). ●● Once all abnormal tissue from the tendon, and retrocalcaneal space are removed, there is a clear view of the Haglund deformity, calcaneal tuberosity, and posterior subtalar joint (Fig. 24.6). ●● The Haglund deformity is resected with an oscillating saw with a typical excised fragment being 2 cm wide × 3 cm tall × 1 cm deep exposing a large insertion footprint for the Achilles tendon repair (Fig. 24.7). ●● At this point, the remaining Achilles tendon insertion is assessed, and it is determined if augmen tation with FHL tendon transfer is required—often if only poor-quality tendon tissue remains or a significant portion of the tendon insertion was débrided, the author typically considers greater than 50% of the tendon having been débrided as an indication to proceed with FHL transfer; how ever, the evidence for exact indications for augmentation is lacking. ●● If no FHL transfer is performed, the tendon is repaired to the insertion with suture anchors. Both single row (two suture anchors) and double row (four suture anchor) techniques have been described. 9 It is at the surgeon’s discretion as to whether a single or double row technique is cho sen. This should be determined taking into consideration the degree of detachment that has been required to be performed. If a robust tendon attachment remains, consideration of less fixation should be given since suture anchors may cause patients pain as well as add unnecessary foreign material burden. If the majority of the tendon or complete detachment is performed, the added fixation of four anchors may be necessary. In the double-row technique, four holes are drilled for suture anchors into the exposed calcaneal footprint (Fig. 24.8A). These holes are spaced ap proximately 15 mm apart. ●● The two proximal suture anchors preloaded with nonabsorbable suture tape are inserted (Fig. 24.8B). The suture from each anchor is then passed through each side of the Achilles tendon approximately 15 mm from the distal tendon insertion (Fig. 24.8C). FIGURE 24.5 A. The Achilles is partially detached from the calcaneal tuberosity to expose further degeneration and bursal thickening. B. The inflamed bursa and fibrosed fat are removed to reveal the posterior-superior calcaneal prominence or Haglund deformity.

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