Clinical examination during consultation is essential. The surgical team collects your functional complaints and analyzes them. Your history is taken into account.
Physical examination is done standing, walking and resting.
We inspect, we look for anatomical landmarks, pulses and the painful areas. An articular examination of the whole lower limb is performed.
We dynamically and comparatively analyze your musculotendinous functions as well as your laxity. We check the absence of neurological deficit.
Depending on the orientations given by this examination, other specific tests may be carried out.
Paraclinical examinations are used. Standard x-rays are often needed. The appropriate incidences will be prescribed by your family doctor or surgeon.
Some pathologies require additional investigations.
Conflicts of tissue or bone, tendinous or ligamentous lesions, most often require an assessment by ultrasound or MRI.
Bone disorders (bone cysts and other tumor lesions), fractures, evaluation of bone stock may justify the use of CT.
Sometimes injection of an iod contrast solution is required for the examination. We will ensure the absence of allergy.
The aim of clinics is to define the diagnosis and discuss with you about the best treatment options.
BIOMECHANICS of FOOT & ANKLE
Ankles support weight of the body.
Their tridimensional motion plane is sagittal. Constraints are very high. Talus, distal tibia and the medial malleolus delimits the joint. Articular capsule and ligaments give stability. Muscles and their aponeuroses provide the movement.
Foot architecture is sometimes represented as the model of a torsion bar. There are three main contact points (posterior, anteromedial and anterolateral). These points are connected by two arches (internal and external).
It includes diagnosis and treatment of fractures, metatarsalgias, hallux valgus pathology, toes deformations, arthritis & rheumatisms.
Depending on the patient, one may use open surgery, mini-invasive surgery or percutaneous techniques.
CONGENITAL & EVOLUTIVE DEFORMITIES
Rheumatoid arthritis produces various deformities. The implementation of a surgical treatment will require to check your medical treatment before surgery, in collaboration with your specialist rheumatologist.
Painful and severe arthritis can be fixed by arthrodesis techniques. It is all the more advised when deformities are pronounced.
Isolated motor deficit with peripherical neurologic involvement as well as severe tendon lesions (that occur when there are deformities) may require tendon transfers. Articular mobilities shall have to be preserved.
Arthroscopic techniques for the treatment of ankle diseases, cover many indications of treatment.
- focal cartilaginous lesions (osteochondral lesions of the talus (OLTs),
- extensive cartilaginous lesions (osteoarthritis and rheumatism)
- foreign bodies
- tendinous and ligamentous diseases
- some forms of inflammatory rheumatism in collaboration with the rheumatologist.
- some traumatic and infectious indications.
These treatments can often be performed on an ambulatory basis. Sometimes a tourniquet is used during surgery. This technique can be performed anteriorly or posteriorly depending on the operative procedure