San Antonio Sports Medicine Associates Foot & Ankle Surgical Fellowship

15 y/o F volleyball player came in for dislocated ankle joint. Now s/p closed reduction in the ED. See pre and post reduction images below, also got a post red CT. No fractures appreciated, no Maisonneuve. Clearly has syndesmosis injury with loss of tib-fib overlap and loss of anatomic position of the fibula in the fibular notch on axial CT. Getting an MRI primarily to examine the ankle cartilage and will then return for pre-op visit. Let's hear some opinions on this!: 1. How are you fixing/stabilizing the syndesmosis? Tightrope, rigid, one of each? How much syndesmotic fixation, etc? 2. Who is doing a primary lateral ankle repair? 3. Anyone doing a deltoid repair? Hope to have some good discussion with this!

Mid 40’s female with progressive HAV with generalized ligament laxity with hindfoot Valgus. MTJ is stable with STJ neutral. Another case of coronal rotation from proximal to distal of the first met. I decided upon a MCO and Triplane correction Lapidus. There was NO lateral release done or manipulation of the sesamoid except for isolated coronal rotation of the first met at the TMT. Over the last few years I am paying much more attention to midfoot and hindfoot pathology that promotes HAV. #treace #bunion #lapidus #Acfas #wbct

A new published paper that I contributed to looking at HAV. This was a prospective, 24 month, multi center look at Lapiplasty. This was so much work on the data collection side. My staff were heroes. If I do it again, I will hire a research coordinator, as I underestimated the work in data collection and time. This is one of the first times I have seen the finalized data and results. If you ever have a doubt in the authenticity of the research that Treace does, sign up to be a part on one of these studies and you will leave with no doubt in these projects. I have done other studies for FDA and other Bunion studies , but none of those compared to this project. I hear about the “ conflict”, as I do get paid for my time to teach for Treace, but here, I was not compensated. I did the surgery, follow ups, staff collected data, X-rays and all records uploaded and reviewed, blinded to me, as were the results. I dont hold myself out to be a PhD in research, but damn this was hard, but worth it. #treace #bunion #halluxvalgus #Lapiplasty # #aofas #acfas #podiatrist ##footandanklesurgery

Here is a fu of a revision case from the fall of 2023. He originally had a silastic implant placed with gromets, for Hallux Rigidus;bc he was a runner and the doc thought he needed to “ maintain the ROM” . Well, that failed as he ran, he is 6’1 and 200lbs. Was revised with #paragon 2cm allograft graft, with autogenous bone in the proximal met and distal phalnx defects and then spanned with a plate. Here is initial rays, immediate post op and now 16 months in, as he just finished his latest half marathon. #halluxrigidus #acfas #aofas

https://lnkd.in/g4iJuRBZ

Here is the FU to this D1 BB player for refracture/nonunion. I thank everyone for your feedback. I decided to revise: -removal of preexisting 5.5mm screw. This screw was in very solid and tight. My thoughts are it’s placement was imperfect and abutting the doral medial cortex and causing a increased tension force at the fracture site. I could have replaced with a larger and shorter screw and directed directly down the canal to better accommodate his anatomy - I chose to open laterally and evaluate the fracture site with the fixation removed, which showed movement, fibros nonunion with sclerosis of the cortices -full debridement of the canal as well as the fracture plane and cortices - autogenous harvest of bone graft, mixed chips, DBM and PRP -dense packing of the canal and cortex -ORIF with #paragon plate and screws with compression.

#5amclub #acfas great meeting and a exciting day ahead. I always like to sample the local fitness culture in any place I travel. I have found some fitness nirvana here in Phoenix at #eosfitness good wo, pray, shower and be ready for the day of friends, residents, Fellows and learning.

The #5amclub is up and going. Worked out, prayed, took out the garbage and had to rake some leaves and bag bf I left. Now we can begin tje day! Convincing Seth Ashraf to become a member😊he is not good in the am. I think I can have upcoming Fellows live at our house in the guest apartment and each day I can wake them up with the family 😂#surilamin

#5amFellowship