10/09/2015    

QUERIES (CLINICAL)

Query: Forefoot or Rearfoot Reconstruction?

 

My patient is a 66 year old fairly sedentary female, 5’3”, 165lb. PMH: HTN (well controlled), hypercholesterolemia-controlled, lower back pain-chronic. Past surgical Hx: L total knee s/p 10 years without complications, B/L foot surgery s/p 16 years, procedures unknown. HPI: chief complaint is pain wearing shoes due to digital deformities, no complaint of mid or rearfoot pain. Her goals are simply to be able to put her foot in a “normal” shoe without severe pain.

 

Pre-op x-rays

 

The question in the pre-operative discussion is should one press for the total reconstruction of the mid/rearfoot and forefoot or simply correct the forefoot with something like a 1st MTPJ arthrodesis and repair of the lesser digits at the MTPJ?