Revision of the Failed Bunion Surgery

Complications and failures of corrective surgery for hallux valgus are not infrequent, and their reported rates vary widely. This is at least partly because of the variety of surgical techniques performed as well as a lack of consensus regarding what constitutes a successful outcome. Some of the most commonly encountered reasons for failure include recurrence, hallux varus, nonunion, and malunion. These problems present a challenging scenario for both the patient and surgeon. A comprehensive understanding of these complications and a nuanced, critical analysis of each case is paramount to effective management of failed surgery for hallux valgus. There are several strategies for both minimizing complications in surgery for hallux valgus and salvaging a successful outcome through revision surgery.

[Second Köhler disease]

Les auteurs rapportent 17 cas de la deuxième maladie de Köhler. Il s'agit de jeunes femmes (13 cas), qui ont consulté pour des douleurs métatarso-phalangiennes unilatérales de type mécanique. La maladie touche la deuxième tête métatarsienne dans 14 cas. Le diagnostic est posé grâce à la radiologie: le stade III est retrouvé dans 11 cas. Nous avons opté pour l'intervention de Gauthier: Ostéotomie de dorsiflexion de la tête métatarsienne par résection cunéiforme à base dorsale de la zone nécrotique. Les suites opératoires sont bonnes et l’évolution est favorable pour nos patients, avec un recul moyen de 3 ans.

Hyperphalangism, facial anomalies, hallux valgus, and bronchomalacia: a new syndrome?

We report on a boy with hyperphalangism, partial syndactyly, facial anomalies, and diffuse bronchomalacia, born to a nonconsanguineous French-Canadian couple. To our knowledge, this is a hitherto undescribed syndrome.

Common foot problems. Relieving the pain of bunions, keratoses, corns, and calluses

Many of the painful foot problems seen in adults are easily treated. Bunions and bunionettes often respond to a change to wide, soft-toed shoes or sandals and the temporary use of a mild anti-inflammatory agent. Initial treatment of plantar keratoses is trimming and use of cushioning shoe inserts. Diffuse keratoses may require reconstructive surgery if metatarsal deformity is the cause. Seed corns and soft corns respond to trimming, and alleviation of pressure with padding and wearing of open-toed shoes is beneficial in these lesions as well as in hard corns. Surgical resection of any underlying exostosis may be required for hard or soft corns or "pump bumps," which are caused by pressure from the shoe's heel. In all cases, patients should be advised to change to shoes that provide plenty of room in the toe box and that minimize friction on painful areas.

The painful foot

The inventive physician may find ways of making releasing cuts or openings with existing shoes to alleviate points of pressure. Many patients will suffer misery of pressure in shoes without giving a thought to cutting them, or opening them to allow for more freedom of movement. Releasing cuts may be made along seams, or between sole and upper with leather inserts to increase shoe size at points of major need for improved fit. Soft shoes may be resorted to. Elasticized material or sandals are preferable to the hard, resistant leather which aggravates so many lesions in our offices. Shoes custom made for disordered feet are very expensive. They may have to be ordered for some feet deformed beyond the capacity for ordinary shoes. Again, unless foot care is convenient and helpful in offsetting pain, the patient will usually not comply. Careful explanation of objectives for present and future is as important here as in any condition treated by family practitioners.

Association of Wolff-Parkinson-White syndrome with congenital abnormalities of hands and feet

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