Lexington, United States
Lexington, United States

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Putnam R.,Moore Center for Orthopedics
Techniques in Foot and Ankle Surgery | Year: 2014

Metatarsal fractures are very common, and it is useful to group these fractures into fractures of the first metatarsal, fractures of the central metatarsals (metatarsals 2, 3, and 4), and fractures of the fifth metatarsal. Proper treatment of these fractures is essential to avoid a poor outcome.Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence. © 2014 by Lippincott Williams & Wilkins.


Feinblatt J.,Oregon Orthopedic and Sports Medicine Clinic | Smith W.,Moore Center for Orthopedics
Techniques in Foot and Ankle Surgery | Year: 2014

The literature on treatment of advanced arthritic changes in the lesser metatarsophalangeal joints is sparse. Options include fusion, resection or interpositional arthroplasty, biological resurfacing, as well as silastic or metallic joint replacement. Little data surround the use of a metallic hemiarthroplasty of the lesser metatarsal heads, and clinical outcomes data for the mid-term to long-term results is currently nonexistent.Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence. © 2014 by Lippincott Williams & Wilkins.


PubMed | Moore Center for Orthopedics, Surgical Director, West Virginia School of Osteopathic Medicine, Des Moines University and Treace Medical Concepts
Type: Journal Article | Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons | Year: 2016

To better understand the mechanical characteristics of biplane locked plating in small bone fixation, the present study compared the stability under cyclic cantilever loading of a 2-plate locked biplane (BPP) construct without interfragmentary compression with that of a single-plate locked construct with an additional interfragmentary screw (SPS) using surrogate bone models simulating Lapidus arthrodesis. In static ultimate plantar bending, the BPP construct failed at significantly greater load than did the SPS construct (556.237.1N versus 241.66.3N, p=.007). For cyclic failure testing in plantar bending at a 180-N starting load, the BPP construct failed at a significantly greater number of cycles (158,32250,609 versus 13,71810,471 cycles) and failure load (242.525.0N versus 180.00.0N) than the SPS construct (p=.002). For cyclic failure testing in plantar bending at a 120-N starting load, the results were not significantly different between the BPP and SPS constructs for the number of cycles (207,64645,253 versus 159,33469,430) or failure load (205.022.4N versus 185.033.5N; p=.300). For cyclic testing with 90 offset loading (i.e., medial to lateral bending) at a 120-N starting load, all 5 BPP constructs (tension side) and 2 of the 5 SPS constructs reached 250,000 cycles without failure. Overall, the present study found the BPP construct to have superior or equivalent stability in multiplanar orientations of force application in both static and fatigue testing. Thus, the concept of biplane locked plating, using 2 low profile plates and unicortical screw insertion, shows promise in small bone fixation, because it provides consistent stability in multiplanar orientations, making it universally adaptable to many clinical situations.

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