drgeraldyeo

Keyhole bunion corrections at 6 weeks post op. Doing well and back in normal shoes. There is evidence that patient satisfaction is greater without needing to correct the 2nd toe hammer toe once bunion correction is maintained.

Thanks St Vincent's Hospital for the invite to be on the foot and ankle panel at our latest GP symposium, helping educate the GP's in regards to our commonest foot and ankle pathology.

Don't think I'll ever be a movie star, but it was fun to be under the cameras again to help make some videos on various arthroscopic, toe fusions and flat feet reconstruction procedures.

Thanks again Dr Vakili for coming along to observe and learn the intricacies of total ankle replacements with us last week. Dr Vaikili is a long term colleague and friend of more than 10 years. Always nice to catch up and talk about how our practice has changed and grown through the years.

How technology has changed. This patient had a similar issue on his contralateral ankle, and we opted to do a hind foot fusion nail only 2 years ago. He was happy with his mobility but when his right ankle started to go the same way came back asking for similar treatment, but we opted to go for an ankle replacement instead, and he hasn't been happier since.

Travelled to Perth to give my colleague and friend Dr Tim Unsworth-Smith a hand with this tricky revision of a loose ankle replacement. We both learnt alot from the experience, ankle replacements are making significant waves in the foot and ankle world, the ability to revise these rather than opt for a fusion gives patients better freedom of movement, decreased pain and improved mobility.

Quite significant hammer toe deformities that required fusion of the PIPJ's and excisional arthroplasties of the MTPJ's for arthritis and subluxed joints.

This patient had previously undergone necrotising fasciitis to her medial calf/ankle, and the skin was extremely scarred, the presumption being the nec fas potentially scarred the tendons/intrinsics of the foot causing the deformities.

It was a pleasure to head up to Hervey Bay to help a friend and colleague Dr Navi Bali with his total ankle replacements.

 As these are still a fairly new and involved technique, it was great to be able to offer helpful tips and tricks to other surgeons to improve how we can deliver this ever evolving surgery to you, our patients.

Flat foot reconstruction for a tibialis posterior tendon tear. Good restoration of the arch with repair of the tib post tendon tear, which I try to do more often than an FDL tendon transfer. The talonavicular coverage was adequate so I did a calc shift rather than a Evans calcaneal lengthening.

Valgus ankle predominantly driven by the ankle arthritis, hindfoot was neutral. Corrected with an Inbone total ankle replacement. I feel the Inbone construct more solid with the weight distribution through the tibia makes more sense for longevity of the ankle replacement. Time will tell.

Another keyhole bunion correction for your Monday week. A common misconception is that the "bunion" needs to be shaven away, and this is not always the case. The medial eminence looks more prominent because of the deviation of the metatarsal, combined with rotation of the metatarsal head, hence why keyhole bunion correction is beneficial - allowing a 3D correction of the deformity by correcting rotation as well. Something you can't do with open surgery.

Large traction spurs/calcification in the heel can be linked to insertional Achilles tendonitis causing pain & rubbing in shoes etc.

Excision of the heel spur, calcification and Haglunds deformity with repair of the Achilles tendon.

Bad trimalleolar ankle fracture that had significant fracture blisters. Although there's evidence that there's minimal risk of operating through blisters I still prefer to wait for them to dry out, so patient was placed in external fixator and regular wound dressings with silver to dry the blisters out quicker.

This patient had an old injury causing a fracture of his midshaft tibia which healed but caused post traumatic ankle arthritis. Fortunately his long leg films didn't show any angulation of his tibial shaft, mainly translation.

We sent him for a Prophecy total ankle plan which confirmed he mainly had a 2cm leg length discrepancy and valgus angulation in the ankle about 6 degrees.

We opted for an Inbone ankle replacement to accommodate the increased stress likely from the leg length discrepancy rather than the translation of the tibia or valgus of the ankle.

Crossover toe deformity requiring fusion of bilateral 1st MTPJ's and excisional arthroplasties to the lesser toes with pinning to allow the soft tissue to adjust.

Patient is allowed to flatfoot weight bear in bilateral post op shoes. Pins will be removed at 6weeks.

Total ankle replacements done with patient specific implants 3D printed to match your deformity and ankle characteristics, reduce surgeon error & operating time, while ensuring the best fit for your ankle replacement. This was a size 1 tibia and talus, the smallest size available, still fits well. The added medial malleolus screw is a must to reduce stress risers in small bone.

Bad arthritis of the 1st metatarsophalangeal joint associated with a "bunion" deformity can be corrected with a fusion.

Post op shoe for 6-8weeks weight bearing and now free to get into comfortable shoes.

When your patient is so happy and creates their own collage of their feet so you don't have to!

.beisenov as requested the x-ray pictures of patient how 2 weeks post her bunion correction and hammer toe correction.

Well looks like everyone had been crossing their toes for good luck last week, so I unfortunately might have taken some of their fortune away. Have a good Monday everyone!

Thanks again Device Tech for the invite to talk on private practice and to run a foot and ankle lab for our up & coming surgeons. It's always daunting venturing into private practice on your own and i always wish had someone to point all the necessary tips and tricks you could use to expand your business further.

Post traumatic arthritis is still the most common cause of arthritis in the ankle. This patient had quite significant stiffness to dorsiflexion and couldn't even go barefoot around the house because she could barely get her heel down. Three months post up and she is walking barefoot around the house for the first time and is very happy with her progress.

Bad fracture dislocation of ankle. Deltoid ligament was pulled off medially so this was repaired back with anchors. Joint is now more stable and aligned. Out of the boot today at 6 weeks.

Happy Chinese New Year to all! Been away for a while, so here's to a good start to the new year for all.

Bunion key hole surgery 3 months post op, normal shoes and activities!

This patient developed arthritis after resection of a giant cell tumour many years ago. Decided to go with an Inbone because of the relative unknown effects a fused syndesmosis may have on an ankle, hoping the Inbone stem will distribute more force away from the ankle. Medial malleolus measured 9mm on the plan, so a prophylactic screw was placed to prevent a stress riser.

Bunions commonly run with hammer toes. In this case I still prefer to repair the plantar plates to restore the hammer toes. Good to be back in business!

Happy new year everyone. Good to be back working. Update, our patient with the 2 stage triple fusion and ankle replacement is doing well so far, so we'll he's keen to have the other side done!

Correction of talar inclination and flat foot as you can see in photos will provide better alignment, mechanics and hopefully with time show that there will be less stress and increased longevity from our ankle replacements.

Another bunion saved keyhole! We don't need to shave these lumps away anymore, translation and correction of rotation of the head will remove the lump without the need to make big long cuts or trim excess bone.

3 months post keyhole bunion correction and plantar plate repair to the 2nd toe. Not crossing the toes for luck anymore I'm afraid!

Bad trimalleolar fracture dislocation of the ankle. Open wound medially, washed and placed in an external fixator temporarily and definitive fixation couple of days later. Immediate weight bearing and exercises in a Moonboot for 6 weeks.