Injury to the metatarsals can be seen in a wide variety of patient populations and is often underrated in terms of long-term outcomes and severity. Although commonly seen in industrial settings secondary to direct, heavy equipment injury, it can also present indirectly by a seemingly minor mechanism. Due to the important role the metatarsals play in ambulation and proper foot function, careful treatment and recognition of these injuries requires not only an ability to recognize but to appropriately treat such injuries. In addition to radiographic findings, soft tissue damage and sequelae can compound the patient's prognosis and recovery. This lecture provides the basis tenets toward recognizing and treating various metatarsal insults that will be encountered in clinical practice. Although many methods of fixation have been identified over the years, a basic description of principles is outlined from which each surgeon can build upon. Please use this lecture as a guide in treating metatarsal trauma, keeping in mind that each patient must be treated as a unique case and that subjective and objective findings, combined with good clinical judgment, should take priority in each case

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The columnar approach to tibialis posterior tendon dysfunction is one that isolates either the medial or the lateral column as the primary factor in the pathogenesis of the deformity. This philosophy de-emphasizes the role of the subtalar joint and the position of the heel with its therapeutic options. THis presentation discusses the formulation of such an approach and provides the information that will enable the technical execution of these procedures.

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This lecture by Dr. John Steinberg discusses the use of Apligraf,
the only currently available FDA approved bi-layered cell therapy

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