53: Surgical Tx Tailor's Bunion - Smith

Question 1

what angle is being measured on 5th met in this picture?

Answer 1

lateral deviation

Question 2

what angle being measured here?

Answer 2

5th met declination angle

Question 3

what are the surgical tx options for tailor’s bunion?

Answer 3

• exostectomy (removing the bump)
• arthroplasty (removing 5th met head)
• osteotomy
  
  • capital (head)
  • shaft
  • basilar (base)

Question 4

when would orthotics be used for tx?

Answer 4

functional etiology (ex: compensated varus deformity)

Question 5

name procedure

Answer 5

exostectomy

+ quick

+ fast healing time

+ immediate WB in surgical shoe

Question 6

last resort tx tailor’s bunion

Answer 6

arthroplasty b/c joint destructive

(-) retraction of 5th toe

• associated with implants

+ fast healing time

Question 7

name the capital osteotomies

Answer 7

• hohmann
  
  • transverse osteotomy of met neck (difficult fixation)
  • (-) complications = undercorrection, delayed or non-union, transfer lesion
• reverse wilson
  
  • oblique cut distal lateral to proximal medial (better screw fixation)
  • similar complications to hohmann
• chevron/”mini austin”
  
  • v osteotomy in the head
  • easy to fixate, stable
  • similar complications
• mercado
  
  • distal closing wedge in subcapital bone with apex proximal lateral (take out an oblique wedge)
  • technical difficulty
  • complications (-) hinge fx, fixation failure/retrieval (removal due to prominence)

Question 8

see an “x” on top of screw - what size is it?

Answer 8

1.5 mm or 2.0 mm screw

Question 9

what is a yancey surgery?

Answer 9

• closing wedge at metatarsal shaft
• increased technical difficulty
• fixation
• NWB (all the distal procedure you can WB)
• complications (-) hinge fx, delayed/nonunion, retrieval, failure

Question 10

what is a gerbert surgery?

Answer 10

• Basilar Closing Wedge
• Increased Technical Difficulty
• Healing? watershed area at 5th metatarsal base
• Fixation
• NWB
• Complications