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A 10-year prospective study was carried out on arthrodesis surgery of the major tarsal joints of the foot. The guiding principle of the study was that foot symmetry would be preserved, except where both feet were deformed. Correction in the frontal, coronal, and sagittal planes would be used to restore normal talocalcaneal relationships. In patients with normal relationships, triple, subtalar (talocalcaneal), and isolated tarsal arthrodesis would be carried out by iliac-crest-inlay grafting to preserve tarsal relationships. In 41 patients, 47 arthrodeses were carried out. There were 31 triple arthrodeses, 10 talocalcaneal fusions, four talonavicular fusions, and two naviculocuneiform fusions. In patients with deformity, significant improvement in the angles of anteroposterior talocalcaneal divergence and lateral talocalcaneal convergence was recorded. There were 27 good results, 15 fair results, and five poor results. Supplementary bone grafting and the use of internal fixation improved the rate of arthrodesis.

Superficial disorders of the forefoot are frequently seen in any office practice. Soft corns, ingrown toenails, plantar calluses, and plantar warts are the most common of these disorders. Their etiology, recognition, and operative and nonoperative management are discussed.

Metatarsalgia is the symptom of pain in the region of the metatarsophalangeal articulations. In a careful analysis of 98 patients who presented with complaints of forefoot pain, 23 distinct diagnoses were made as to the etiology of their pain. These diagnoses were grouped under primary metatarsalgia, secondary metatarsalgia, and pain under the forefoot. Specialized tests, such as stance phase cholesterol-crystal force plate analysis and intraarticular or digital nerve block, are helpful in determining the diagnosis and the likelihood of effective treatment.