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Orthopedic surgeon at HSS, Foot and Ankle specialist, Manhattan, New York
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Here are intraop & postop images of yesterday's case by Dr. Matthew Wells @matthew_eric_wells  and Martin Army Community Hospital.

ANKLE, TALUS, AND CALCANEUS FRACTURES S/P ATV ACCIDENT IN 82F

PROCEDURE: TALUS FRACTURE CLOSED REDUCTION PERCUTANEOUS SCREW FIXATION, TIBIA-TALUS-CALCANEUS (TTC) NAIL FIXATION

HPI: An 82-year-old female presents after an ATV rollover accident on her farm in which the ATV crushed her left ankle. On presentation to the ER, she complained of pain and deformity in her left ankle and an inability to ambulate. The emergency department providers performed a closed reduction and splinting prior to consulting orthopedic surgery. Other than her left ankle injury, the patient denies any other injuries.

PMH: The patient's past medical history is significant for hypertension and hyperlipidemia.

PE: The physical examination reveals no open wounds. There is significant edema of the left ankle. The left lower extremity is neurovascularly intact.

Do you agree with the treatment? Why or why not?

Share your opinion with the Orthobullets community about this case by joining the discussion and taking the poll on our site for FREE CME! (Link in bio)
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Here are intraop & postop images of yesterday's case by Dr. Gregory Foote (@Doctor.Foote) and MercyOne (@MercyOne_Iowa).

BUNION DEFORMITY IN 53F

PROCEDURE: 1st metatarsocuneiform arthrodesis with patient-matched cutting guides and lateral soft-tissue release (Lapidus). Osteotomy of 1st proximal phalanx.

HPI:  The patient is a 53-year-old female with a history of rheumatoid arthritis who presents with localized pain over a prominent medial bump on her medial right foot. Her symptoms have been increasingly limiting, resulting in a restriction of her functional capacity and baseline activity level. She is highly active and an avid runner.

PMH: Past medical history is notable for rheumatoid arthritis (RA).

PE: On focused physical exam of her right foot, there is a visible hallux valgus deformity.  There is mild instability at the tarsometatarsal (TMT) joint. There are overlying skin changes of the medial 1st MTP joint with erythema and tenderness. There is no pain with passive flexion or extension of the 1st MTP joint.

How would you manage this patient?

Share your opinion with the Orthobullets community about this case by joining the discussion and taking the poll on our site for FREE CME! (Link in bio)
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Resumen de los días 2, 3 y 4 | 26° Congreso SAMeCiPP y 11° Congreso FLAMeCiPP – Córdoba 2026 ✨

Cada jornada representa una oportunidad para seguir aprendiendo, intercambiar experiencias y actualizar conocimientos en patologías y formar amistades con médicos que aman también la cirugía de pie y tobillo.

La formación continua nos permite incorporar nuevas herramientas para brindar una mejor atención y acompañamiento a nuestros pacientes.
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