Journal of the International Foot & Ankle Foundation

The Zadik labiomatrixectomy

Steven Edwards — 2023-01-01

The Zadik labiomatrixectomy is a permanent solution for chronic nail pathology in the medically compromised patient. A 63-year-old male builder was referred for the surgical correction of his chronically symptomatic onychauxic hallucal toenail that had been resistant to conservative care. A Zadik labiomatrixectomy procedure was performed under local anaesthetic to physically remove the nail germinal matrix in toto. The Zadik labiomatrixectomy provides a safe and effective solution to chronic nail pathology in the medically compromised patient.

Tibial avascular necrosis in a trimalleolar ankle fracture

Edee Renier — 2023-01-01

Fractures involving the distal tibia and fibula are challenging to treat, and can have debilitating sequelae. While many fractures can be treated conservatively, open reduction with internal fixation for displaced or unstable variants is the standard of care. Complications in treatment of these complex fractures are relatively common and often unavoidable. The authors present the case study of a 49 year-old female who underwent open reduction with internal fixation of a closed Danis Weber type-B trimalleolar ankle fracture and suffered avascular necrosis of the anterior lateral tibial plafond. This patient underwent successful trimalleolar ankle fracture fixation surgery, and subsequently suffered collapse of the anterior lateral aspect of the tibia 14 weeks following her index procedure. This case study lends an example of avascular necrosis causing devastating osseous collapse despite timely and robust fracture fixation.

Is there radiographic remodeling of the metatarsals in hallux valgus and pes planus?

Rajesh Botchu — 2023-01-01

Foot conditions such as hallux valgus and pes planus cause altered load across the metatarsals. We performed a retrospective review of 98 patients who had foot radiographs performed at our institution for forefoot pain. The patients were divided into two groups based on their age and whether they had normal or altered foot alignment. We found that there is a mild increase in the intramedullary thickness of the third metatarsal in patients with hallux valgus (HV) and HV with pes planus (PP), which we postulate to be due to altered biomechanics and relative decrease in load on the third metatarsal.