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Source: The ABC’s of Applying for Fellowship

Moderator: L. Marie Keplinger, DPM, FACFAS
Panelists: Andrew Kapsalis, DPM, AACFAS; William Adams, DPM, AACFAS; Timothy McConn, DPM; Ryan Scott, DPM, FACFAS

Dr. Adams Articles

Patrick A. DeHeer, DPM; William Adams, DPM; Faye-Rose Grebenyuk, DPM; Eric Meshulam, DPM; Kory Miskin, DPM; Tiffany Truong Koch, DPM; Corey Groh, DPM
J Am Podiatr Med Assoc (2016) 106 (6): 387–397.
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Dr. Adams Presentations

Brian Elliott, DPM, FACFAS Major Health Partners – Renovo Orthopedics
Wil Adams, DPM, AACFAS Fellow, American Health Network Hancock Regional Hospital – Orthopedic Department
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William Adams, Chief Resident, DPM, PGY-III Community Health Network – Indianapolis, IN Prospective Fellow at American Health Network – Indianapolis, IN
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William JE Adams, DPM, AACFAS Fellowship Trained Foot and Ankle Surgeon Hancock Foot and Ankle, Orthopedics Department
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William Adams, DPM, AACFAS Hancock Regional Hospital – Orthopedics Dept.
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William Adams, DPM, AACFAS Fellow – American Health Network
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Wil Adams, PGY-III, CHN – American Health Network Monthly Meeting
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Service areas include: Greenfield, Hancock County, Knightstown, New Palestine, and Indianapolis, Indiana.

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Disclaimer: Dr. Wil Adams, DPM Greenfield, IN Please remember that medical information provided by Dr. Wil Adams in the absence of a visit with a health care professional, must be considered as an educational service only. The information sent through e-mail should not be relied upon as a medical consultation. This mechanism is not designed to replace a physician’s independent judgement about the appropriateness or risks of a procedure for a given patient. We will do our best to provide you with information that will help you make your own health care decisions. Many external links have been provided on this site as a service and convenience to our patients and other visitors to our website. These external sites are created and maintained by other public and private organizations. We do not control or guarantee the accuracy, relevance, timeliness, or completeness of this outside information. If you require to find out more please email us at info@adamsfootsurgery.com. This website is not intended for viewing or usage by European Union citizens.

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Feb 26

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$37 yo male fell during bad snow storm. Fibula was badly fractured with large butterfly fragment due to double spiral. Medial and posterior malleoli fractured as well but not comminuted. We typically dissect out posterior mall, then move to fibula, restore length and fixate, then back to post mall to reduce and fixate. Always avoid over dissecting posterior malleolus. Only make small incision at top of fracture line to avoid compromising PITFL and blood flow to posterior tibia. To make the large fragment at the posterior fibula sturdy before we could restore length, we used a small cannulated screw. Once 3 pieces became 2, we then used a huge Inge lamina spreader (in neuro sets). Our typical spreaders would not span the fragment. Once we used this to restore length, we plated underneath/in front of PB muscle belly, sliding plate under perforators. Used ball spike pusher, and Hintermann for Post mall. Challenging but fun case$

37 yo male fell during bad snow storm. Fibula was badly fractured with large butterfly fragment due to double spiral. Medial and posterior malleoli fractured as well but not comminuted.

We typically dissect out posterior mall, then move to fibula, restore length and fixate, then back to post mall to reduce and fixate. Always avoid over dissecting posterior malleolus. Only make small incision at top of fracture line to avoid compromising PITFL and blood flow to posterior tibia. To make the large fragment at the posterior fibula sturdy before we could restore length, we used a small cannulated screw. Once 3 pieces became 2, we then used a huge Inge lamina spreader (in neuro sets). Our typical spreaders would not span the fragment. Once we used this to restore length, we plated underneath/in front of PB muscle belly, sliding plate under perforators. Used ball spike pusher, and Hintermann for Post mall.

Challenging but fun case ...

adamsfootandanklesurgery

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Feb 20

Open

$28 yo mom vs skateboard... Nothing really that remarkable about this case except the fact that the anterior colliculus fracture was the hardest part of this tri-mall to reduce. Getting the posterior mall, and the fibula out to length were simple with a Hintermann, despite the comminution at the lat malleolus. However, once we flipped the patient supine, it took the same time supine as it did prone. When we started to reduce the colliculus it would want to rotate. Maybe in hindsight a small hook plate would be helpful? If you look closely at the lateral you can see the posterior aspect of the colliculus fracture is not perfectly reduced. We elected to use a single 3.0 screw as that’s all we could squeeze in.$

28 yo mom vs skateboard...

Nothing really that remarkable about this case except the fact that the anterior colliculus fracture was the hardest part of this tri-mall to reduce. Getting the posterior mall, and the fibula out to length were simple with a Hintermann, despite the comminution at the lat malleolus. However, once we flipped the patient supine, it took the same time supine as it did prone. When we started to reduce the colliculus it would want to rotate. Maybe in hindsight a small hook plate would be helpful? If you look closely at the lateral you can see the posterior aspect of the colliculus fracture is not perfectly reduced. We elected to use a single 3.0 screw as that’s all we could squeeze in. ...

adamsfootandanklesurgery

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Feb 14

Open

Major date changes noted for our Fellowship.

https://www.ahni.com/health-services/specialty-care/foot-ankle-care/fellowship.html

Current Fellows are @jbonvillian6 and @tylerdmckee

Reach out to them with questions, please. ...

adamsfootandanklesurgery

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Feb 11

Open

41 yo male with unremarkable pmhx aside from smoking 1/2 PPD. Is 6 wks out from Nanoscope, deltoid and ATF/CF ligament repair with Internal Brace x 2, and Fibertaks x 2.

Patient jumped off tall trailer at work ~10 months ago causing distal tib contusion, small non-displaced OLT, and severe sprains to deltoid, and lateral collaterals. We treated the patient with cast immobilization due to severe tenderness. He was then in a walking boot until 10 weeks, a lace-up brace, and PT. At ~7.5months patient was still having what he figured was unacceptable pain. Tricky because this was Workman’s comp. We repeated MRI; contusion gone, & chondral defect hardly noticeable, but ligaments both medial & lateral still edematous, & showed chronic attenuation/disruption.

At this point arthroscopy, direct deltoid & lateral collateral repair was recommended.

At this 6 week follow up he’s doing very well. He is getting transitioned to shoe with lace-up brace, and PT at 8th week. He is swollen & a little weak, but pain free medially, and laterally, for first time in a long time to him.

Many Modified Bröstrum’s get performed everyday across the country, and account for the lion’s share of ankle ligament repairs. Inversion ankle sprains are #1 most common orthopedic injury seen in the ED, yet the amount of times the deltoid component is even considered I think maybe under addressed? This is the 4th deltoid I’ve repaired as sequelae from a bad sprain in 2.5 months. Each patient had different story. 1 pt’s initial trauma was over 3 years old (with previous scope & Bröstrum from another provider), but each had chronic residual medial ankle pain that never improved. Each patient including my own was told it’ll eventually resolve on its own. ...

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Jan 29

Open

$Story as old as time.... 30 yo male falls off ladder from 9ft. 1 ppd smoker. Fortunately lumbar and hip imaging negative. Half of the posterior facet was incarcerated in the calcaneal body. Following the schanz pin shake we used elevators to hoist and rotate superior, and posterior, the facet back to alignment. (Böhler’s angle was 10 degrees. Radio called it minimally displaced) Sinus tarsi approach in lateral decubitus position is the way we do it. Minimal skin healing issues and to date have not met a fracture that deserved lat extensile. If its truly that comminuted then its an arthrodesis for us. Patient doing well so far...All get arthritis, but how much can we minimize it? Early active ROM NWB to prevent excessive stiffness is important, we think.$

Story as old as time.... 30 yo male falls off ladder from 9ft.
1 ppd smoker.

Fortunately lumbar and hip imaging negative.
Half of the posterior facet was incarcerated in the calcaneal body. Following the schanz pin shake we used elevators to hoist and rotate superior, and posterior, the facet back to alignment.

(Böhler’s angle was 10 degrees. Radio called it minimally displaced)

Sinus tarsi approach in lateral decubitus position is the way we do it. Minimal skin healing issues and to date have not met a fracture that deserved lat extensile. If its truly that comminuted then its an arthrodesis for us. Patient doing well so far...All get arthritis, but how much can we minimize it?

Early active ROM NWB to prevent excessive stiffness is important, we think. ...

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DR. ADAMS IS WORTH THE SHORT DRIVE and has many patients from McCordsville, Fortville, Pendleton, Carmel and Fishers Indiana.

adamsfootandanklesurgery