HIGH YIELD II

Question 1

When do we need to stay on a path of

conservative care for a juvenile HAV?

Answer 1

• Physical/developmental concerns prohibit NWB status
• Ligamentous laxity
• Neuromuscular disorders

Question 2

goals for operative treatment?

Answer 2

restore functional anatomy
improve pain
prevent progression

Question 3

growth plate closure for females age 14? males age 16?

Answer 3

full foot growth achieved for both

Question 4

what to avoid in operative tx?

Answer 4

joint destructive procedures

fibular sesamoid excision

Question 5

what ST procedures can we do?

Answer 5

sesamoid apparatus rotates laterally so FHL realignment

medial capsulorrhaphy
adductor tendon transfer

Question 6

osseous procedures?

Answer 6

Austin
reverdin
mitchell
wilson
peabody

Question 7

fixation for CBWO for the first two screws?

Answer 7

1st screw=anchor

2nd screw=compression screw

Question 8

common CBWO complications?

Answer 8

elevation

shortening

Question 9

what is used for juvenile HAV with hyper mobility?

Answer 9

osseous procedure-lapidus

used for:
large IMA
instability of 1st RAY
flexible flatfoot
met primus elevatus

Question 10

osteotomy should be performed at the _____ of the osseous angulation?

Answer 10

apex, called CORA (correction at apex of deformity)

Question 11

what do we use to fixate during a lapidus?

Answer 11

k wire
staple
screw
plate

Question 12

-Only for the juvenile HAV with open growth plates
-Arrest the lateral physis of the 1st met base and allow medial physis to grow
-1st met adducts as it continues to grow,
closes down the IMA
-“Theoretical” gradual decrease of the IMA

what is this?

most important consideration?

Answer 12

epiphysiodesis

timing