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Jay Lieberman,
DPM, FACFAS |
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Residency Question of the Week:
Why do residents prefer to work with Vilex Screws? (See answer below). |
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The existence of the McGlamry elevator is definitive proof of the saying “necessity is the mother of invention.” Transverse plane digital deformities were impossible to treat appropriately until the development of the McGlamry elevator. Arthroplasties, digital fusions, tenotomies and/or capsulotomies typically failed, leaving a residual deformity or painful medial stump of the proximal phalanx.
Transverse plane instability of the MPJ may develop as a result of partial or complete destruction of the suspensory or collateral ligaments. These ligaments attach both the proximal phalanx and the metatarsal to the plantar plate. Once the ligament is compromised, the flexor sheath will migrate medially and the toe will drift as well.
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The McGlamry elevator works by releasing the unabated
medial pull of the suspensory or collateral ligament. |
CASE #1: Case number one demonstrates a typical pre-subluxation syndrome. When I do these types of cases, I use a “Z” type incision to prevent contracture of the MPJ postoperatively. A dorsal medial capsulotomy is then used to expose the joint. Next, the elevator is inserted in the fashion described above. If a residual deformity is still evident, I will resort to a Weil osteotomy to decompress the joint.
CASE #2: Pre-subluxation syndrome exacerbated by an iatrogenically induced hallux varus. This demonstrates the importance of repairing the hallux varus as well.
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The McGlamry elevator is also useful in releasing the adhesed sesamoids in functional hallux limitus. |
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Answer to the Residency Question of the Week:
The cutting flutes are extremely sharp. It takes very little effort to insert the screw, reducing the risk of fracturing your osteotomy. All Vilex screws have a low head profile and have hand-sharpened triple cutting tips.
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| The main business of Vilex is orthopedic and podiatric bone surgery. Vilex® offers a broad range of cannulated screws, locking and conventional plates, small joint implants, a subtalar Arthroereisis implant, and ring and mono-rail external fixation devices. In addition, through United American Medical (UAM, acquired in 2001), Vilex® offers a whole array of power equipment such as wire drivers, drills, and oscillating/reciprocating saws. |
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Vilex® also offers saw blades, guide wires, drills and burrs. All Vilex Internal Fixation products are manufactured in the USA. Call 800.521.5002 for more informatin of visit www.vilex.com today.
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