Primary functions of heel and forefoot fat pad - shock absorber at heel strike, energy dissipation, load bearing, grip and insulation. •Reliability of weight bearing heel pad thickness measurements by ultrasound has been determined by Rome et al. Importance of soft tissue fillers has been recently popularised by Coleman. Harvesting done by standard low pressure liposuction using small cannula. Grafting using small needle depositing the small globules of fat in multiple layers of soft tissue. There is an expectation that up to 50% of the fat will be lost and so upto 19mls of fat placed per foot. Patients were kept NWB for 4–6 weeks post op and then allowed to mobilise fully. Case notes were prospectively collated and analysed. Pre and post-op ultrasound scans were performed to document the depth of the heel/forefoot fat pad. Clinical pictures were taken and post-op patient satisfaction scores were done as well.Introduction:
Methods and materials:
Salvage procedures on the 1st MTPJ following failed arthroplasty, arthrodesis or hallux valgus surgery are difficult and complicated by bone loss. This results in shortened first ray and transfer metatarsalgia. We present our experience of using tri-cortical interposition grafts to manage this challenging problem. Between 2002 and 2009 our department performed 21, 1st MTPJ arthrodeses using a tri-cortical iliac crest interposition graft. Surgical fixation was achieved with a compact foot plate. We performed a retrospective review from the medical notes and radiographs along with American Foot and Ankle scores which were collected prospectively. We analysed the following parameters: time to radiological, requirement for further surgery, lengthening of 1st ray and any post operative complications.Background
Methods
