Biomedical subjects
Publications and source records attributed to S M Spinner.
The authors present a study of the treatment of Morton's neuroma. Sixty patients, involving 65 feet treated, were studied. Conservative treatments were compared to surgical excision of the neuroma. As a result of the findings in this study, the authors recommend surgical excision as the initial treatment of choice.
Surgical correction of the flexible acquired flatfoot has long been subject to procedures based on an unsound understanding of the true pathomechanics of the deformity. With the advent of modern biomechanics and the concept of planal dominance, procedure selection can become a more exacting science. A classification system based on the progression of symptoms, used in concert with a firm understanding of the primary and compensatory deformities can simplify the process of selecting combined procedures to deal with a particular foot type.
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A discussion is presented about objective correction criteria for hallux abducto valgus surgery. A historical review of commonly used procedures performed for correction at various levels of first ray deformity is related. Based on ideal criteria for base wedge osteotomies, a new template and procedure for base wedge osteotomies derived from computer-augmented graphics is described in detail. This procedure has been referred to as a convergent angled osteotomy (CAO) and effectively reduces the metatarsus primus adductus angle with minimal loss of length, cortex to cortex apposition in closure, relative lengthening with plantarflexion if desired, and a capacity for very stable rigid internal fixation that optimizes recovery from base wedge reduction. Case histories are also presented.
The pathomechanics of hallux abducto valgus involve a complex series of interactions. The interpretation of these requires a sound understanding of anatomy, biomechanics, and radiographic criteria. This paper attempts to describe these relationships through the parameters allowed by conventional roentgenographic techniques and to provide insight into their analysis.