OKOJ, Volume 13, No. 6

Techniques for Soft-tissue Coverage of the Foot and Ankle

Reconstructive soft-tissue coverage of the foot and ankle remains a challenging clinical problem. Its successful achievement requires selection of the optimal surgical approach to a specific situation in a particular patient, and excellent soft-tissue handling to minimize wound complications, whose risk is increased by a suboptimal tissue bed and medical comorbidities. The best outcomes in reconstructive tissue coverage of the foot and ankle result from the timely recognition of postoperative issues in wound healing and from early reconstruction with grafts or flaps to provide stable soft-tissue coverage. This article reviews the various options for soft-tissue coverage of the foot and ankle and the indications for their use, as well as their outcomes.

    • Keywords:
    • flap coverage

    • lower extremity

    • pedicled flap

    • free flap

    • random flap

    • Subspecialty:
    • Foot and Ankle

Classifications of Distal Radius Fractures

Fractures of the distal radius are among the most common fractures seen in the emergency room. Their management ranges from a period of immobilization alone through open reduction and internal fixation with a number of available devices. The choice of treatment for a particular fracture of the distal radius depends on the degree of its articular involvement and its perceived stability. Many systems have been described for classifying fractures of the distal radius in attempts to guide their treatment. This article reviews the most well-known systems for classifying these fractures.

    • Keywords:
    • distal radius fracture

    • Colles fracture

    • Smith fracture

    • Barton fracture

    • chauffeurs fracture

    • Subspecialty:
    • Hand and Wrist

In-office Carpal Tunnel Release

Carpal tunnel release can be done effectively and safely with minimal resources in an office setting as opposed to the operating room. We successfully used in-office carpal tunnel release with local anesthesia and without the need for a tourniquet, sedation, or the full complement of surgical staff at a local Veteran Administration medical center. This article describes our protocol for patient selection, surgical setup, and technique for in-office carpal tunnel release.

    • Keywords:
    • open carpal tunnel release

    • local anesthesia

    • wide awake hand surgery

    • WALANT protocol

    • Subspecialty:
    • Hand and Wrist