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The authors describe a technique with a single anterior incision and fixation with an internal button, the Endobutton. The procedure is performed through a 5-cm transverse skin incision, and the tendon is sutured to the Endobutton with 2 number 5 Ethibond sutures. Surgical repair in the depths of the muscular forearm is not required, because the tendon is simply sutured external to the wound. The Endobutton delivers and locks the tendon into a hole in the radial tuberosity. The Endobutton technique was used in 12 patients who were allowed early active mobilization. All were satisfied, returned to activities, and regained grade 5 strength. Average flexion was from 5 degrees to 146 degrees with 81 degrees supination and 80 degrees pronation. No neurovascular complications or synostosis occurred. In cadaveric studies the average distance from the biceps tendon were ulnar artery 6 mm, median nerve 12 mm, and posterior interosseous nerve 18 mm. The average distance from the posterior interosseous nerve to a Steinman pin advanced through the proximal radius was 14 mm. This technique is a safe and effective method of repair of distal biceps tendon avulsion that allows active mobilization with minimal risk of complication.

We describe the medium-term results of a prospective study of 200 total ankle replacements at a single-centre using the Scandinavian Total Ankle Replacement. A total of 24 ankles (12%) have been revised, 20 by fusion and four by further replacement and 27 patients (33 ankles) have died. All the surviving patients were seen at a minimum of five years after operation. The five-year survival was 93.3% (95% confidence interval (CI) 89.8 to 96.8) and the ten-year survival 80.3% (95% CI 71.0 to 89.6). Anterior subluxation of the talus, often seen on the lateral radiograph in osteoarthritic ankles, was corrected and, in most instances, the anatomical alignment was restored by total ankle replacement. The orientation of the tibial component, as seen on the lateral radiograph, also affects the position of the talus and if not correct can hold the talus in an abnormal anterior position. Subtalar arthritis may continue to progress after total ankle replacement. Our results are similar to those published previously.

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The aim of this study was to address concerns regarding maintenance of correction of foot deformity after soft tissue Ilizarov distraction in relapsed clubfeet. We retrospectively reviewed the results of Ilizarov surgery of 19 rigid clubfeet in 14 children. The postoperative follow-up was at least 5 years (range, 5-10 years). All patients were assessed using the International Clubfoot Study Group score. This is a comprehensive scoring system published in 2003, incorporating morphological, functional, and radiological assessments. Patient and parent satisfaction was also assessed. Using the International Clubfoot Study Group score, 14 of the 19 feet managed by the Ilizarov soft tissue distraction technique were graded good or excellent. Only 1 patient experienced recurrence of the deformity. Subjectively, 13 of the 14 children in the study were satisfied with the result of the treatment. The study confirms that the short-term good results reported previously are maintained at least 5 years after the operation. There are no other similar studies with a minimum 5-year follow-up.

Although there is evidence of continuity of the Achilles tendon by three weeks after tenotomy, healing is not complete until at least twelve weeks. The time needed for the tendon to completely heal should be taken into consideration before a revision Achilles tenotomy is planned.

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MIS calcaneal shift osteotomy has an advantage over open conventional open technique in cases where the skin is under tension like in combined calcaneal lengthening osteotomy. With experience, the procedure can be faster than an open procedure.