OKOJ, Volume 13, No. 1

Metabolic Bone Disease in the Foot and Ankle

Metabolic bone disease results either from the uncoupling of normal bone formation from bone resorption or errors in metabolism. Although the effects of such disease are systemic, their manifestations in the foot and ankle vary with the functional demands on the bones, articulations, and soft tissues in this region of the body. Often, these problems present to the foot and ankle surgeon as incidental findings in the evaluation of other, more common problems. In other instances, structural insufficiency and overt fracture or joint inflammation occur as direct results of the pathophysiology underlying bone disease. In either case, recognition of the essential elements of metabolic bone disease is critical to its diagnosis and either direct intervention or prompt referral for its treatment.

    • Keywords:
    • osteopetrosis

    • enostosis

    • osteopoikilosis

    • Camurati–Engelmann disease

    • osteopathia striata

    • melorheostosis

    • pyknodysostosis

    • osteoporosis

    • osteomalacia

    • hyperparathyroidism

    • gout

    • Paget disease

    • Subspecialty:
    • Foot and Ankle

Negative-Pressure Wound Therapy in the Upper Extremity

Negative-pressure wound therapy creates a closed, subatmospheric dressing for wound containment. The application of this technique has broadened and has become common in treating chronic and acute wounds. The following brief article will provide the surgeon with a basic foundation for the use of negative-pressure wound therapy in treating wounds of the upper extremity.

    • Keywords:
    • negative-pressure wound therapy

    • upper extremity

    • wound management

    • skin grafting

    • Subspecialty:
    • Trauma

    • Hand and Wrist

Surgical Hip Dislocation in the Pediatric Population

Surgical hip dislocation is an approach to the hip that provides 360° of exposure to the head of the femur and full access to the acetabulum and labrum, while safely preserving the blood supply to the femoral head. The safety of surgical hip dislocation has been established in both anatomic and clinical studies, and has subsequently been applied in the treatment of a variety of hip disorders common in pediatric patients, including Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, and femoroacetabular impingement. This article reviews the pertinent anatomy and technique of surgical hip dislocation, the potential complications associated with this procedure, and the applied indications of this approach in treating disorders of the hip in pediatric patients.

    • Keywords:
    • Ganz surgical hip dislocation

    • slipped capital femoral epiphysis

    • femoroacetabular impingement

    • Legg-Calvé-Perthes disease

    • Subspecialty:
    • Pediatric Orthopaedics