Hints & Tips – Forefoot Surgery and its Complications

Description

In this informative talk, Howard Davies discusses the evolution of surgical techniques in treating foot deformities, particularly in patients with rheumatoid conditions. Starting with a light-hearted acknowledgment of the accumulated wisdom from earlier contributions, Davies emphasizes the transformative role of DMARDs (disease-modifying antirheumatic drugs) in reducing severe deformities seen in previous generations of patients.



He reflects on the present-day challenges, such as moderating patient expectations and transitioning away from bespoke footwear towards more conventional options. The aim of modern surgery is not only to relieve pain but also to restore functionality and aesthetics, aligning with contemporary standards of footwear preferences.



Davies outlines essential principles for foot and ankle surgery, including the importance of joint preservation and careful evaluation of deformities. He discusses various surgical approaches, highlighting strategies like fusion of joints for stability over resection procedures that tend to yield poor long-term outcomes. The presentation includes insights into specific techniques such as Weil's osteotomy and distal metatarsal metaphyseal osteotomy (DMMO), noting their benefits, risks, and the significance of maintaining anatomical integrity post-surgery.



With anecdotes and practical tips drawn from his extensive experience, Davies stresses the imperative to assess patients thoroughly, coordinate with rheumatology colleagues regarding medication management, and plan surgeries meticulously to achieve optimal results. He concludes with the catchphrase "get it right the first time," underscoring the critical nature of accurate diagnosis and effective surgical intervention.

DOI: 10.1302/3114-221472

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