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Cheilectomy With Decompression Osteotomy for Treatment of Hallux Limitus and Rigidus: A Retrospective Study With 5-Year Outcomes

Shields, John; Gambhir, Neil; Alben, Matthew; Kogan, Alina; Greenberg, Paul; Delmonte, Rick
We examined outcomes following metatarsophalangeal joint cheilectomy with decompression osteotomy to evaluate the efficacy of this technique for treatment of hallux limitus/rigidus. At a minimum follow-up of 5 years, we identified 94 patients who fit the inclusion criteria. Chart review was performed to obtain range of motion (ROM) of the first metatarsophalangeal joint (MTPJ) preoperatively and at 6 weeks, 6 months, and 5 years postoperatively. Additionally, time to traditional shoe gear return, need for revision arthrodesis, radiographic findings, and postoperative visual analog scale (VAS) pain scores were reviewed. Statistical analysis was conducted by 1-way analysis of variance with post-hoc analysis and independent sample t-test. At an average follow-up of 6.3 ± 0.9 years, 42.3% (33/78) of females and 25.0% (4/16) of males reported limited ROM of the first MTPJ with 5 patients requiring first MTPJ arthrodesis. MTPJ ROM improved on average from 11.0° to 36.3° by 5-year minimum follow-up after surgery (p < .001). Analysis of variance revealed a significant difference of the preoperative ROM when compared to all postoperative time points (F[3,368] = 69.4, p < .001). Mean postoperative VAS pain scores after decompression osteotomy of the 5 patients who required MTPJ fusion were higher when compared to the rest of the patient cohort at final follow-up (7.4 ± 0.6 vs 1.5 ± 1.3; p < .001). Cheilectomy with decompression osteotomy for treatment of hallux limitus/rigidus leads to satisfactory long-term outcomes.
PMID: 36117052
ISSN: 1542-2224
CID: 5332992

Metastasis of Cutaneous B-Cell Lymphoma Affecting the Metatarsal Head: A Case Report [Case Report]

Huchital, Michael; Hoda, Syed T; Delmonte, Rick; Greenberg, Paul
There are few reported cases of non-Hodgkin's lymphoma metastasis to bone in the lower extremities. The authors present a case of cutaneous B-cell lymphoma thought to be in remission, with metastasis to the first metatarsal head with involvement in the synovial tissue of the first metatarsophalangeal joint. Following excision of the lesion, no further treatment was determined to be necessary. The patient was to be observed for local recurrence.
PMID: 33872366
ISSN: 1930-8264
CID: 5342042

Ankle Block

Chapter by: Kay, Joseph; Delmonte, Rick; Greenberg, Paul M
in: Hadzic's textbook of regional anesthesia and acute pain management by Hadzic, Admir (Ed)
New York : McGraw-Hill Education, [2017]
pp. ?-?
ISBN: 0071717595
CID: 2745682

Ankle block

Chapter by: Kay, Joseph; Delmonte, Rick J; Greenberg, Paul M
in: Textbook of regional anesthesia and acute pain management by Hadzic, Admir [Eds]
New York : McGraw-Hill, Medical Pub. Division, 2007
pp. 545-553
ISBN: 9780071449069
CID: 2056042

The Mau and Ludloff midshaft osteotomies

Chapter by: Greenberg, Paul
in: McGlamry's comprehensive textbook of foot and ankle surgery by McGlamry, E; Banks, Alan S [Eds]
Philadelphia : Lippincott Williams & Wilkins, 2001
pp. ?-?
ISBN: 9780683304718
CID: 2056052

Retrospective analysis of the Mau osteotomy and effect of a fibular sesamoidectomy

Bar-David, T; Greenberg, P M
The purpose of this study was to evaluate retrospectively outcomes of the Mau osteotomy for hallux abducto valgus deformity. Twenty-two patients were evaluated by the senior author on an average of 14 months (range, 3-34 months) following their surgery. Preoperative and postoperative intermetatarsal (IM) and hallux abductus (HA) angles were evaluated as well as range of motion of the first metatarsophalangeal joint and patient satisfaction. The mean preoperative IM and HA angles were 16.1 degrees and 35.8 degrees. The mean reduction in IM and HA angles was 10.5 degrees and 23.5 degrees, respectively. Joint range of motion was 58 degrees of dorsiflexion (range, 42 degrees-80 degrees) and 11 degrees of plantarflexion (range, 0 degree-20 degrees). There were no cases of delayed healing or avascular necrosis. There were two patients (9%) with radiographic values consistent with hallux varus; however, neither patient had a clinical appearance of hallux varus and neither patient was displeased with the outcome. Ninety-one percent of patients returned to a soft shoe or sneakers in an average of 5.1 weeks following surgery. Eighty-two percent of patients had no pain at the time of their evaluation, and 96% of patients stated they were satisfied or very satisfied with the surgery. Comparing the subgroup of patients who underwent a Mau-Reverdin procedure with another subgroup undergoing a Mau-Reverdin fibular sesamoidectomy, there was a 3.7 degrees greater reduction of IM angle and 6.7 degrees greater reduction in HA angle in the subgroup with the fibular sesamoidectomy.
PMID: 9638546
ISSN: 1067-2516
CID: 2052482

Postoperative narcotic and nonnarcotic analgesics

Elleby, D H; Greenberg, P M; Barry, L D
Narcotic analgesics may be used safely in most patients. Common adverse effects may be managed successfully with naloxone. PCA is a newer approach to the management of postoperative pain. The authors' survey results indicate that most podiatric physicians would benefit from the understanding of the considerations in the patient subgroups with renal or hepatic dysfunction that required postoperative pain control.
PMID: 1586908
ISSN: 0891-8422
CID: 2052472

The Akin osteotomy and its modifications

Chapter by: Greenberg, Paul
in: Comprehensive textbook of hallux abducto valgus reconstruction by Marcinko, David E [Eds]
St. Louis : Mosby Year Book, 1992
pp. 63-86
ISBN: 9780801631719
CID: 2056022

Tendon transfers of the foot and leg?

Chapter by: Greenberg, Paul
in: Medical and surgical therapeutics of the foot and ankle by Marcinko, David E [Eds]
Baltimore : William & Wilkins, 1992
pp. ?-?
ISBN: 9780683055498
CID: 2056012

General principles of Hallux Abducto Valgus reconstruction

Chapter by: Greenberg, Paul
in: Comprehensive textbook of hallux abducto valgus reconstruction by Marcinko, David E [Eds]
St. Louis : Mosby Year Book, 1992
pp. 19-61
ISBN: 9780801631719
CID: 2056032