Flatfoot does not automatically make a bunion a Lapidus. A 36-study review found TMT instability may be consequence, not cause, and mild asymptomatic pes planus did not justify routine fusion. Treat the actual mechanical failure, not the label. Ritchie et al., 2026.

Locked in. 🔒 Good luck to every PGY-3 taking ABFAS exams this week!

Who remembers the STA-Peg? I removed one Monday, approximately 20 years after flatfoot surgery. Significant inflammatory fluid and findings consistent with detritic synovitis. We placed these during my training. Decades later, they still teach us. Who else remembers?

Significant cavus may require STJ fusion. Maly et al. found fusion reduced ankle contact area 17.9% and increased peak pressure 31.6%. The lesson is not to avoid fusion. Use the fusion to correct deformity, restore the tripod, and reassess the first ray. FAO, 2026.

Proud to represent podiatry at the 30th Notre Dame Orthopaedic Society Symposium. Orthopedic and podiatric surgeons learning together, great discussion, and time with friends. Add fall on campus and football, and this is why I keep coming back. ☘️🏈

Podiatry should lead on plantar fasciitis. Every specialty owes patients the same evidence standard. Our review found 4 uncontrolled studies. I cannot support routine embolization until stronger efficacy and safety data exist. Rogers et al. JAPMA. 2026;116:74.

Results from 60 MIS hammertoe surgeons: Screw 47% No fixation 23% K-wire 15% Both 15% PIP arthrodesis was screw-dominant, while phalangeal osteotomy usually used no fixation. Procedure matters more than a universal fixation standard. #MISFootSurgery

Same 88 feet: MPA-defined hyperpronation was 78.4% or 19.3%, depending on the threshold. A normative cutoff is not a validated surgical target. Understand the measurement before planning correction. Lalevée et al. Foot Ankle Surg. 2023.

The foot moves. The range is restricted. In this calcaneonavicular coalition case, subtalar motion was preserved; midtarsal motion was restricted. Assess each separately. Normal-motion clip: a different patient. Golshteyn & Schneider. Clin Podiatr Med Surg. 2022.

The level of release matters. 15 paired cadavers: median dorsiflexion gain 14.7° with Strayer vs 8.0° with proximal medial release (P=.001). Greater motion does not prove better clinical outcomes. Michlin et al. Foot & Ankle International. 2026.

My AI literature bot, Jerry, finally gave a paper 10/10. Savannah Santiago, Bijan Najafi, and I wrote it. 😂 AI bias? Excellent taste? It’s a teaching-fit score, not scientific certainty. Yes, he’s named after Jerry Garcia. Jerry remains employed.

Shortening >4 mm: 7/31 scarf, 0/66 META, 0/37 Lapidus feet. Transfer metatarsalgia was not measured. Correct the deformity while preserving first-ray length and sagittal support. Pui et al. Foot Ankle Orthop. 2026.

53 MIS surgeons have responded. We need 22 more to reach 75. If you perform osseous MIS hammertoe correction, add your experience to this anonymous 60-second survey. Aggregate results will be shared. docs.google.com/forms/d/e/1F…

Can reconstruct a flatfoot. Needs a second opinion on the orthotic order form. 😂 A loving roast of our residents, and those of us teaching them. Biomechanics belongs in every surgical residency. Two pieces of wood and a hinge won’t cut it. #Podiatry #Biomechanics

MIS correction + DMMO: 47.5% vs 11.7% radiographic recurrence, yet greater functional improvement at 12 months. Unadjusted cohorts cannot establish causation. Every osteotomy needs a defined purpose. Genuth et al. Foot Ankle Orthop. 2026.

An intact brevis is only part of the story. In 9 cadaveric specimens, 50% resection reduced stiffness by 18.8% versus native. What remains matters. So does how it functions. Mechanics, not proof of clinical outcomes. doi.org/10.1177/107110072110…

After PMGR, 18/20 plantar DFUs closed within 4 weeks, but 10/20 recurred with recurrent gastroc tightness. Closure ≠ durable correction. I favor Baumann or Strayer over TAL due to overlengthening, Achilles insufficiency, and calcaneal gait risk.

29 MIS surgeons have responded, and the range of information is already fascinating. Help us reach 75+ responses. If you perform osseous MIS hammertoe surgery, take the anonymous 60-second survey or share it with a colleague: docs.google.com/forms/d/e/1F…

Proud APMA submitted my written testimony supporting H.R. 7905/S. 4070. H.R. 7905 was included in today’s House hearing. I thank committee members for considering better access to diabetes foot care. Join me. Urge Congress to act: votervoice.net/mobile/APMA/C…

Two pieces of wood and a hinge. Congratulations, you can operate on a cabinet. 😂 To be a great surgeon, you have to be a biomechanist. Teach it through patients, deformities and surgical decisions. The patient is not a cabinet. 🦶 #Podiatry #Biomechanics