surgery

Changes in Tibiotalar Area of Contact Caused by Lateral Talar Shift


BY PAUL L. RAMSEY, M.D.*, AND WILLIAM HAMILTON, M.D.t, WILMINGTON, DELAWARE
Iro,,i t/U Alfred I. duPont Institute, Wilmington

ABSTRACT: A carbon black transference technique was used to determine the contact area in twenty-three dissected tibiotalar articulations, with the talus in neutral position and displaced one, two, four, and six millimeters laterally. The greatest reduction in contact area occurred during the initial one millimeter of lateral displacement, the average reduction being 42 per cent. With further lateral displacement of the talus the contact area was progressively reduced but the rate of change for each increment of shift was less marked.

 

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ARTHRODESIS OF THE FIRST METATARSOPHALANGEAL JOINT FOR 1-IALLUX VALGUS, HALLUX RIGIDUS, AND METATARSUS PRIMUS VARUS

BY DUNCAN C. MCKEEVER, M.D., HOUSTON, TEXAS


The multiplicity of procedures devised for the radlical cure of hallux valgus, metatarsus
primus varus, and hallux rigidus, and the failure of any one of them to become generally accepted as the best. procedure for these conditions, would indicate that none of them yields a high percentage of good results. Some of the fascial and tendinous sling procedures
for the correction of metatarsus primus varus are undoubtedly applicable in young pa
tient.s and will produce satisfactory results; however, only the test. of time will determine
whether they  ‘ill prevent the ultimate development or recurrence of the hallux valgus
and its accompanying disability. Correction of varus of the first metatarsal must continue
to be essential in any operation for hallux valgus which hopes to yield a permanent cor
rection. The principle inherent in the McBridlc operation would seem to be the only
anatomically reasonable contribution so far to functional correction of this deformity.  

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