Foot & Ankle Surgeon
Dr. Adams is an Indiana native. He attended Indiana University-Bloomington where he met his wife Allison. He got degrees in Nutrition Science, Biology and Chemistry. Dr. Adams then got his doctorate from Kent State College of Podiatric Medicine where he was a Dean’s List student. He then came back to Indianapolis to do his surgical residency, and was Chief resident at Community Health Network. He stayed in Indianapolis, and completed advanced training in a Fellowship focusing on Adult and Pediatric Reconstruction. During his Fellowship, Dr. Adams worked part-time for Hancock Orthopedics. He has remained there since.
Dr. Adams in the operatory
Dr. Adams enjoys teaching as he helps educate, and train the surgical residents at Community Health Network, and the Fellows at American Health Network. He actively participates in research, and peer reviewing for national journals.
He is also a consultant for orthopedic device companies where he is afforded the opportunity to help train, and design with other surgeons across the country.
When Dr. Adams is not practicing medicine he enjoys spending time with his family, hunting, snow skiing, traveling, and riding single track on his dirt bike, or mountain bike.
Dr. Adams has special interests in the following areas:
This 58 yo female had previous Calc slide, PT augmentation, and gastroc recession.
The large synthes screw was errantly placed into the STJ. As usual, the slide was not powerful enough along with ancillary soft tissue procedures to restore decent alignment.
MRI showed spring ligament damage, and large defect in posterior facet.
Triple and TAL were performed to revise and realign. Patient is 10 wks out in after photo showing nice unions.
@extremitymedical hardware, and biofuse pro allograft were utilized.
Happy New Year! Thanks to all for a great 2022.
Thanks to @extremitymedical for great metal
47 yo male falls from tree stand.
Unremarkable pmhx aside from 1/2 ppd smoker.
Sinus tarsi incision is the ticket.
Nanoscope nicely aids reduction.
Its nice to get the calcaneus out of varus, but ultimately , its all about the joint surfaces.
The nanoscope allows easy access/visualization to the entire joint. Being able to show a patient the joint surface clinically is a nice practice adjuvant.
This patient healed great with zero incision healing issues.
@dkblacklidge taught me this technique - ideal for application at a county hospital. Its prevented need for flaps, I&D’s and surgeries that go with lat extensile.
@indyfootandankle
The midfoot arthrodesis sometimes gets a bad rap…and there isnt a ton of literature on the NC arthrodesis specifically.
Regardless, in this 54 yo female factory worker her chronic midfoot arthrosis was under appreciated on plain film. After failing injections - some specifically aimed at diagnostically blocking the deep peroneal nerve with US guidance, and getting incomplete pain relief, she decided to proceed with a fusion after a MRI further delineated what all articulations were involved
At 12 wks she had nice unions. She was kept immobilized/NWB for 7 wks.
She is pain free and back to work. She is a smoker but stopped for surgery. She is non DM.
Our current fellow @dsved @indyfootandankle has assisted with some of the lit thats out. …. We used @extremitymedical hardware to build a low profile compressive construct.
Does advanced age effect union rates? Some studies suggest so.
In this 61 yo male that installed custom floors for a living, we treated recalcitrant sinus tarsi syndrome and posterior tibial tendinitis with a double arthrodesis + TAL.
He complained of 1st MTP arthrosis as well, so we elected to avoid fusion for now with joint sparing cheilectomy as this may better allow kneeling required at work.
His post op films were taken at 10 wks with solid union evident. Still working on MTP ROM.
We used @extremitymedical hardware, and their BioFuse Pro bone allograft to supplement.
Do you have a graft protocol in place for certain age groups?
This 74 yo male we’ll call RB4 asked we post his pictures to our website and social media as he was thankfully thrilled with his result. Not a perfect result but we obliged.
He had his left foot “fixed” years ago, and after that “gave up” on foot surgery…. We are revising that side soon. It has a failed prosthesis and more.
His painful areas on the right were the 1st MTP, plantar 2nd MTP., and 2nd toe.
We utilized a 1st MTP arthrodesis , and a FHL transfer. His great toe was so contracted when we pulled it out of valgus he immediately developed a terrible flexion contracture. Transferring the FHL to the dorsum of the phalanx remedied this.
We then did a 2nd met head resection, FDL transfer, and PIPJ arthrodesis.
In the xrays and clinical pictures he is 10 wks post op, and doing well.
@extremitymedical hardware used!
This bloody OLT (osteochondral lesion of talus) was encountered in a 41 yo male that sustained a Weber C after being tackled by a drunkard from behind. We used a k-wire to microfracture at time of ORIF. I prefer to use the 1.9mm Nanoscope due to its incredible flexibility, and field of view. Additionally, it can be run at very low pressure ingress that prevents excessive joint capsule distention and joint trauma.
It’s also a breeze for staff to setup.
Do you routinely scope your fractures (calc, ankles)? I think it both assists reduction, and also allows us to treat OCL’s. Literature shows high incidence.
Unstable tri mall fixed via traditional approach as the PM fracture was almost a wafer. This patient had Ehlers-Danlos - unsure of which subtype. Regardless, elected not to use tourniquet to avoid vascular compromise as in some EDS pts vascular fragility is an issue. Thankfully her incisions healed well, and she’s doing well.
Extremity Medical hardware used — Stable AF set. Their low profile spoon on the anatomic fib plate has been awesome.
23 yo male had a previous extra-articular, or FLEXIBLE flat foot recon (elsewhere) with a gastroc recession, anterior calc osteotomy and a Kidner. It was reported the patient also had a CN bar coalition resection.
Unfortunate for this patient a TC coalition was not identified pre or intra-operatively. Additionally, the CN bar was not fully excised either. This patient’s foot was not flexible.
3 years after this young man had his index surgery he was miserable, and did not understand why.
We repeated MRI imaging & discovered the 2nd coalition. The under resected CN was noted on plain film prior to MR.
We had careful discussion with patient that due to the lack of flexibility of his hindfoot articulations, these joint sparing procedures were not appropriate. To definitively treat his pain, and improve alignment a fusion would need to be performed.
We thankfully were able to resect both coalitions through standard ST approach. We felt removing the Evans wedge didn’t provide any benefit to the patient. Additionally, patient was in severe equinus again so we elected to lengthen again with a TAL.
Pt is now 12 weeks post op as pictured in xrays and very happy.
Shoutout to @gitasreeb for being an incredible MSK radiologist.
Extremity Medical hardware used to revise this case.
This petite 74 yo female had a tough 5 years. She has hx of DM-II.
She had a previous malunited triple by a non foot and ankle surgeon that over time became un-braceable. She had periods where her A1C drifted too high to allow safe recon, and COVID delayed surgery as she needed ECF placement post-op.
She is semi-neuropathic. Her talus had both features of AVN and Charcot. When the MSK radiologist that interpreted her films and I chatted he felt strongly AVN was not certain, and neither was Charcot.
Given the patient’s basic desire to have a limb she could stand on, and reliably wear a brace without the tendency to develop sores, I felt an ankle fusion and a multiplanar midfoot osteotomy would best allow correction.
At 11 weeks post op her ankle fusion is united, and she is full weight bearing in a walking boot. She is starting physical therapy to work on muscle tone and transition to shoe and AFO.
We used fully threaded screws to allow better purchase in osteopenic bone. Using screws also allowed smaller incisions than plating would.
@arthrexmeded
23 yo female came in last year with a bad Lisfranc fracture that she sustained at home, in a low energy twisting injury.
Pt followed up with us 18 months later complaining of hindfoot pain —she attributed to her Lisfranc injury.
After some discussion we regrettably informed her that her sinus tarsi syndrome was a result of her pes planus/flat foot deformity, and unrelated to her midfoot trauma. Thankfully her fusions healed well, and this area was asymptomatic on exam.
Arch supports and sinus tarsi injection was utilized to start….To be continued..
Semi rigid flat foot in a 70 yo female. This is not a finished product. Will follow up with WB films and clinical photos.
49 yo female slips on wet stairs while on vacation.
We used posterior medial approach to fix PM and MM fractures.
Direct lateral for comminuted fibula.
Extremity Medical Hardware used.
She is one of our favorite patients!
Hallux Extensus deformity — Failed Swanson revised with Evans allograft wedge cut into dowel rod, wrapped in Infuse on healthy 82 yo female for arthrodesis.
Canals of met and phalanx debrided meticulously like scrubbing soap scum off shower walls. Prepped with fenestration drill, then grafted. We used rongeur and osteotomes to make the dowel, and press fit joint together, then dorsal bridge plating.
Will post final healed images.
Plain film does not always correlate……
This middle aged male was not ready for an arthrodesis….
6 wk post op films show union.
Patient is working on ROM
@bgelliott14 made me appreciate this osteotomy.
@indyfootandankle
@arthrexmeded
@dsved good job!
@kelpeasy
Bimalleolar fractures often do not need syndesmotic fixation. In this instance, this 75 yo female had mild non diabetic neuropathy, osteopenic bone, and an unstable fibular fracture fragment. Therefore, we elected to use transsyndesmotic fixation to help reduce the fibula, and re-align the mortise. Do you call this a low Weber C, or a Weber B fibula fracture?
Here is the link : https://www.sciencedirect.com/science/article/pii/S1067251622002150
for free access to this article we wrote on the Plantaris’ role in equinus, and why you should be sure to transect during your gastroc recessions. Nice job @kbkindred @dkblacklidge @bgelliott14 @indyfootandankle
Metatarsus adductus + midfoot arthrosis in a healthy 58 yo female.
Patient presented with obvious bunion deformity, but also complained of a painful “bone spur” to the top of her foot.
MRI revealed DJD of 2nd and 3rd TMT , in addition to the angular deformity. Arthrodesis allowed angular correction, and definitive care for DJD.
We added PL to PB transfer to help reduce FF valgus prior to positioning the TMT’s, in this cavus foot deformity.
We started at the 3rd TMT, and worked our way medial. We used a modified Hintermann that allows external compression while we placed the dorsal locking plates at 2 and 3. This allowed us to forego compression screws.
Extremity Medical includes this device in their Omni set, standard.
Pt presented with acute Lisfranc Charcot collapse w/ ulcer and acute OM in medial cuneiform.
We staged the procedures:
-I&D with biopsy + cultures (6 wks oral antibiotics)
-Mini rail application debridement and graft placement - 3 weeks later
-Mini rail removal and debridement and graft - 4 weeks later
-Triple arthrodesis, NC arthrodesis, Lisfranc arthrodesis, and TAL - 9 days later
WB xrays were taken 16 weeks after final surgery demonstrating mostly consolidated fusions
Obvious criticism is medial column beam should have been recessed further. Clinically the beam did not look proud but radiographically it does.
Extremity Medical has an excellent Charcot set with a beam and clip system. The clips straddle the beams where desired, and help prevent back out.
Note: this patient now has 2 reconstructed Charcot feet. The contralateral limb was reconstructed last year, & still healed. See post from 2/19/22
Biocartilage is an excellent adjuvant for OLT’s and has favorable MOCART scores.
Side by side xray is a case just posted recently in a 15 yo female.
FOOT & ANKLE SURGERY
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Before & After Photos
Before and After correction of painful, arthritic bunion deformity
(Note: Skin color changes due to swelling)
Note: Your results may vary
