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21 Cards in this Set
- Front
- Back
- 3rd side (hint)
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When is an Akin osteotomy indicated?
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It is typically used IN CONJUNCTION with a 1st metatarsal procedure for HAV correction.
Specifically an ABNORMAL DASA |
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Describe an Akin osteotomy.
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Resect a wedge of bone out of the prox phalanx to allow for straightening of the toe.
The first cut (proximal cut) is made (5-10 mm away from MPJ) perpendicular to the longitudinal axis of the prox. phalanx. The distal cut is basically how much you plan on resecting, to allow for the toe to become straight. |
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What is most common K wire size used to fix an Akin?
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0.062 is MOST COMMONLY used.
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What do you do if you go to make the cuts in an Akin osteotomy and you end up cutting the lateral cortex?
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You must then use another form of fixation ---
You would use cross K wires to help stabilize it. |
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Typically, what sized screw is used when fixing an Akin?
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2.7 mm Screw
If the foot is really small, a 2.0mm screw |
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A proximal akin shown here can be fixed with what specific K-wire?
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1.6 cm or .062 mm K wire
(same thing) KNOW THIS FOOLIO. |
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What kind of Akin is this?
What's it clinical indication? |
Central (Cylindrical Akin)
Specifically used for SHORTENING. |
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A distal akin is typically indicated clinically how?
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An abnormal hallux IP angle.
A normal hallux IP angle is LESS THAN 10* |
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Describe post operative course for a distal akin.
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4 weeks in SX shoe.
Post operative course for a distal akin take an X ray right after the SX After the 1st post op. 4 weeks later. If at 4 weeks there is consolidation, you take the screws out and put them in a sneaker! If you perform an akin with another ostetomy, you follow the ostetomy post-operative course. |
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What are the possible complications of akin?
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1. delayed union
2. angular deviation 3. over correction/under correction |
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Hallux IPJ sesamoid excision is indicated when?
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Indicated for painful hyperkeratosis.
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Describe the SX for sesamoid excision consist of?
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A Medial, plantar, or plantar medial incision.
Identify and remove the sesamoid. Post-op course: Sx Shoe for 2 weeks. -------- You do not want to cut the flexor tendon, if you do--- use Ethibond (nonabsorbale suture) to anchor back where it should go. Difficult process. Dr. Pontius recommends going the plantar approach, split the tendon in half, scoop out the sesamoid, and then suture the tendon. |
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What is the procedure to help get rid of this?
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Hallux Condylectomy for this pinched callus due to abductory twist.
Most of the time, it goes away with bunion sx, but not always. |
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What is shown here, and what is indicated?
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A HALLUX OSTEOPHYTE is seen here. Responsible for a medial pinched callus!
Remove the osteophyte, and then perform a condylectomy and smooth over the bone. |
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Arthrodesis of the IPJ is indicated when?
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Cavus foot
Neuromuscl disease Iatrogenic deformities Hallux hammertoes Traumatic arthritis |
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Hallux IPJ fusions are indicated when?
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Hallux malleus
Hallux varus (maleus) Hallux abductus interphalangus CMT, et al. Post traumatic Iatrogenic Etc. |
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Describe the lag screw technique.
Partially threaded. |
Thread hole (2.0mm)
Countersink -- Depth guage -- Tap (3.5mm) Screw (4.0mm) |
FOR FULLYTHREADED>>
Thread hole (2.5mm) Countersink ** Depth guage -- Overdrill (4.0mm*) Tap (3.5mm) Screw (FTCS) |
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What are the 4 different incisions for hallux IPJ fusions?
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S
T Transverse Elliptical |
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Post op management of a hallux ipj fusion is ______________ weeks in a SX shoe.
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Post op management of a hallux ipj fusion is ____6_____ weeks in a SX shoe.
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Hallux IPJ fusions include the following complications:
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Lack of purchase
Distraction Mal-alignment |
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Capsule tendon balance procedures for HAV correction include the:
Silver McBride/Mod. McBride Bunionectomy Hiss Bunionectomy |
The Purpose is to remove the bump, relocate the sesamoids, and derotate the toe.
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