AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
Moderators/Faculty
08:00
08:20
Other
Registration, coffee and meet groups
08:20
09:40
MODERATOR:
08:20
08:30
Nima Heidari
Lecture
Welcome and introduction to course
Expected outcome:
Anticipate how the course will run with the emphasis on
biomechanics and principles of trauma management as
applied to the foot and ankle
08:30
08:45
Lecture
Initial assessment
Expected outcome:
Explain the concepts of soft tissue reconstruction
Assess the severity of soft and bony tissue trauma in
context of extremity trauma
Assess patients and select appropriate imaging
Elucidate the concept of a timely management plan
based on soft tissue and skeletal injury
Set appropriate priorities
08:45
09:10
Lecture
Soft tissue reconstruction
Expected outcome:
Evaluate options for treating soft tissue problems
Involve plastic surgeons and a combined management
strategy appropriately
Define boundaries of plastic surgical reconstruction
Location/Documents
Vesalius Lecture Theatre
Breakout Area
James Stanley
Duration
20
80
Vesalius Lecture Theatre
10
Stephen Mitchell
Vesalius Lecture Theatre
15
Tom Wright
Vesalius Lecture Theatre
25
1 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
09:10
09:40
Lecture
Patient positioning (interactive demonstration)
Expected outcome:
Position patients appropriately for individual operations
and provide a rationale
09:40
09:55
Tea & coffee
09:55
12:30
MODERATOR:
Moderators/Faculty
Andrew Oppy
Nima Heidari
Location/Documents
Duration
Vesalius Lecture Theatre
30
Vesalius Lecture Theatre
Breakout Area
15
155
2 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
09:55
10:30
Title
Lecture
Biomechanics: Old and new concepts of foot function
Expected outcome:
Formulate principles of the biomechanics of the foot
and ankle
Explain normal function and how it may be preserved
and restored
Justify how management of foot injuries should aim to
maintain and restore structural stability with respect to
balanced alignment and preserve controlled
coordinated intrinsic movements
Explain the importance of plantar aponeurosis and the
reverse windlass mechanism in controlling the
movements of the transverse tarsal joint
Moderators/Faculty
Location/Documents
Duration
David Stainsby
Vesalius Lecture Theatre
35
Lisa Taitsman
Vesalius Lecture Theatre
20
Basic foot structure, stability and function
Brief review of origin and development of plantar
aponeurosis anatomy in mammals
Importance of multi-segmental tie-bar system in human
foot
The plantar pad: anatomy
Refs: Morton, De Doncker and Kowalski, Hicks, Huson
10:30
10:50
Lecture
Pilon fractures - Approaches & fixation options
Expected outcome:
Differentiate between direct and extensile approaches
Evaluate the pros and cons of each
Outline the principles of internal fixation
Compare indications and results with external fixation
3 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
10:50
11:30
Title
Discussion
Case discussions - Pilon/Distal tibia (Groups 1 & 2)
Expected outcome:
Explain the complexities of pilon fractures in clinical
scenarios
Evaluate management options
Plan staged management of these injuries by various
techniques
Moderators/Faculty
Stephen Mitchell; Andrew Oppy
Location/Documents
Versalius Lecture
Theatre
Duration
40
4 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
10:50
11:30
Title
Workshop
ORIF Pilon with 3.5LCP/VA options (Groups 3 & 4)
Expected outcome:
Safely perform direct and extensile approaches to the
distal tibia
Moderators/Faculty
Nima Heidari; Mark Jackson; David
Stainsby; James Stanley; Lisa Taitsman;
Claire Topliss; Tom Wright
Location/Documents
Vesalius Wet Lab
Duration
40
- Anterolateral approach
Position incision correctly
Identify superficial peroneal nerve
Identify ankle joint capsule, incise the joint capsule and
extend incision distally in line with 4th MT to expose
talar neck
Place ½ pin into talar neck for intraoperative distraction
- Anteromedial approach
Position incision lateral to tibial crest
Explain the angiosome of the anterior tibial artery and
posterior tibial artery
Make the distal transverse limb of the incision at the
level or distal to the joint line to facilitate visualisation
Expose talar neck
Place ½ pin into talar neck for intraoperative distraction
Use suture shuttle to pass the plate up
- Posterolateral approach
Position incision between peronei and TA
Identify and preserve sural nerve
Identify the plane between PL/PB and FHL
Incise fascia over FHL
Lift FHL from fibula
Respect the peroneal NV bundle
Observe the posterior syndesmotic ligaments
- Posteromedial approach
5 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
0
Groups swap around
11:30
12:10
Discussion
Case discussions - Pilon/distal tibia (Groups 3 & 4)
Expected outcome:
Explain the complexities of pilon fractures in clinical
scenarios
Evaluate management options
Plan staged management of these injuries by various
techniques
Stephen Mitchell; Andrew Oppy
Vesalius Lecture Theatre
40
6 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
11:30
12:10
Title
Workshop
ORIF Pilon with 3.5 LCP/VA options (Groups 1 & 2)
Expected outcome:
Safely perform direct and extensile approaches to the
distal tibia
Moderators/Faculty
Nima Heidari; Mark Jackson; David
Stainsby; James Stanley; Lisa Taitsman;
Claire Topliss; Tom Wright
Location/Documents
Vesalius Wet Lab
Duration
40
- Anterolateral approach
Position incision correctly
Identify superficial peroneal nerve
Identify ankle joint capsule, incise the joint capsule and
extend incision distally in line with 4th MT to expose
talar neck
Place ½ pin into talar neck for intraoperative distraction
- Anteromedial approach
Position incision lateral to tibial crest
Explain the angiosome of the anterior tibial artery and
posterior tibial artery
Make the distal transverse limb of the incision at the
level or distal to the joint line to facilitate visualisation
Expose talar neck
Place ½ pin into talar neck for intraoperative distraction
Use suture shuttle to pass the plate up
- Posterolateral approach
Position incision between peronei and TA
Identify and preserve sural nerve
Identify the plane between PL/PB and FHL
Incise fascia over FHL
Lift FHL from fibula
Respect the peroneal NV bundle
Observe the posterior syndesmotic ligaments
- Posteromedial approach
7 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
12:10
12:30
Title
Lecture
Biomechanics: Ankle ligaments and ankle stability
Expected outcome:
Formulate principles of the biomechanics of the foot
and ankle
Explain normal function and how it may be preserved
and restored
Justify how management of foot injuries should aim to
maintain and restore structural stability with respect to
balanced alignment and preserve controlled
coordinated intrinsic movements
Explain the importance of plantar aponeurosis and the
reverse windlass mechanism in controlling the
movements of the transverse tarsal joint
Moderators/Faculty
David Stainsby
Location/Documents
Duration
Vesalius Lecture Theatre
20
Vesalius Lecture Theatre
Breakout Area
50
Dissections of the ankle ligaments and effect of ankle
movements
12:30
13:20
Lunch
13:20
15:20
MODERATOR:
Andrew Oppy
120
8 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
13:20
13:50
Lecture
The posterior malleolus and syndesmosis
Expected outcome:
Identify patterns of syndesmotic injury
Describe how to identify these injuries pre and intra
operatively
Compare the relative merits of closed and open
reduction
Evaluate the pros and cons of the different fixation
options
Appraise the management options available for the
missed or late presenting injury
Explain the significance of posterior fragments and the
various morphologies described
Select appropriate imaging modalities
Formulate a management plan
Evaluate the advantages and limitations of different
approaches and fixation techniques
13:50
14:10
Lecture
Diabetic and osteoporotic fractures
Expected outcome:
Define the role of collagen abnormalities and glycation
Maillard reaction neurological and vascular
abnormalities in the generation of Charcot disease
Anticipate special problems posed by both diabetic and
osteoporosis fractures and their management
Formulate appropriate management plans
Differentiate between the treatment of normal fractures
in an individual with diabetes and pathology as a result
of neuropathy resulting in Charcot disease
Moderators/Faculty
James Stanley
Location/Documents
Duration
Vesalius Lecture Theatre
30
Vesalius Lecture Theatre
20
9 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
14:10
14:25
Discussion
Tendo-Achilles Rupture (non-op)
Expected outcome:
Formulate a clear non-operative management plan for
ta ruptures
Describe the anatomy and healing process of injury
Explain the importance of an accelerated functional
rehabilitation program
Outline the indication for operative treatment
Claire Topliss
Vesalius Lecture Theatre
15
14:25
14:40
Lecture
Tendo-Achilles Rupture (operative)
Expected outcome:
Evaluate open and minimally invasive techniques for
repair of tendo Achilles ruptures
Explain the role of an accelerated functional
rehabilitation program
Anticipate complications associated with the operative
treatment of Achilles tendon ruptures and salvage
options
Stephen Mitchell
Vesalius Lecture Theatre
15
10 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
14:40
15:20
Title
Workshop (cadaver)
Explore the syndesmosis/ankle
External fixation of the foot & ankle
Expected outcome:
Safely explore the syndesmosis
Look back through the anterolateral and posterolateral
approaches
Visualise the AITFL and PITFL
Cut these to observe instability of the syndesmosis
Demonstrate open reduction of the syndesmosis
Moderators/Faculty
Nima Heidari; Mark Jackson; Stephen
Mitchell; Andrew Oppy; David Stainsby;
James Stanley; Lisa Taitsman; Claire
Topliss; Tom Wright
Location/Documents
Vesalius Wet Lab
Duration
40
Perform an application of external fixation spanning the
ankle joint to resuscitate the soft tissues and stage
management of complex fractures
Explain the importance of the placement of
transcutaneous fixation components outside the zone
of surgery
Insert proximal pins (5mm) into the tibial crest and
outside zone of surgery
Insert through and through calcaneal Denham pin
(centrally threaded Steinman pin)
1st MT 4mm ½ pin
5th/4th MT ¾ mm pin
A-frame construct
Stirrup under the heel for protection of soft tissues
Alter frame config to accommodate definitive fixation
Insert posterior proximal pin for IM nailing access
Insert posterior calc pin to leave hindfoot nail corridor
11 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
Moderators/Faculty
15:20
15:35
Tea & coffee
15:35
18:00
MODERATOR:
Nima Heidari
15:35
16:10
Lecture
Biomechanics: The coordinated movements of the
tarsal bones
Expected outcome:
Formulate principles of the biomechanics of the foot
and ankle
Explain normal function and how it may be preserved
and restored
Justify how management of foot injuries should aim to
maintain and restore structural stability with respect to
balanced alignment and preserve controlled
coordinated intrinsic movements
Explain the importance of plantar aponeurosis and the
reverse windlass mechanism in controlling the
movements of the transverse tarsal joint
David Stainsby
Location/Documents
Vesalius Lecture Theatre
Breakout Area
Duration
15
145
vesalius Lecture Theatre
35
Pattern of coordinated movements: calcaneo-cuboid,
talo-calcaneal and talo-calcaneo-navicular joints
Brief mention effect upon forefoot distally, and the ankle
and leg proximally
Refs: Lewis, Huson
12 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
16:10
16:30
Workshop (dry bone)
Build your own talus
Expected outcome:
Explain the unique and complex anatomy of the talus
Justify how the shape dictates trajectory and the
position of fixation devices
Mark Jackson
Vesalius wet Lab
Breakout Area
20
16:30
16:50
Lecture
Talus fractures
Expected outcome:
Describe the blood supply to the talus
Define its role in fracture treatment
Explain the timeline for talar fracture treatment
Describe surgical approaches
Evaluate the current evidence
Plan for management of a talar extrusion injury
Lisa Taitsman
Vesalius Lecture Theatre
20
13 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Monday, 03 Apr 2017 (Day 1)
Start
End
Title
16:50
18:00
Workshop (cadaver)
ORIF Talus
Talur neck screws
Malleolar Osteotomy
Expected outcome:
Perform medial and lateral approaches to the talar neck
Visualise the talar neck
Excise navicular tubercle for access to the talar head
Incise ATFL to gain access further posteriorly on AL
side
Perform malleolar osteotomy for approaches to the
posterior half of the talar body
Placement of implants: Apply lateral plate to the ridge
Insert medial screws from the head to the body
Demonstrate antegrade screw placement
Moderators/Faculty
Nima Heidari; Mark Jackson; Stephen
Mitchell; Andrew Oppy; David Stainsby;
James Stanley; Lisa Taitsman; Claire
Topliss; Tom Wright
Location/Documents
Vesalius Wet Lab
Duration
70
14 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
08:00
08:25
Lecture
Coffee & Questions
Nima Heidari; Mark Jackson; James
Vesalius Lecture Theatre
Livingstone; Stephen Mitchell; Andrew
Oppy; David Stainsby; James Stanley; Lisa
Taitsman; Claire Topliss; Tom Wright
08:25
11:40
MODERATOR:
Claire Topliss
08:25
08:50
Workshop
Build you own calcaneum
Expected outcome:
Describe the unique and complex anatomy of the
calcaneus
Justify how the shape of the bone?? dictates the
trajectory and the position of fixation devices
Mark Jackson
Wet Lab Breakout Area
25
08:50
09:10
Lecture
Calcaneal fracture management - Now you see it
Expected outcome:
Describe the relevant local anatomy and the
angiosomes which dictate the placement of the incision
for the extended lateral approach to the calcaneus
Plan a sequence of reduction manoeuvres based on
the anatomy of the calcaneal fracture
Evaluate different plates and screws available for
internal fixation and select appropriately
Explain safe technique wound closure and
post-operative care
Andrew Oppy
Vesalius Lecture Theatre
20
25
195
15 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
09:10
09:40
Lecture
Calcaneal fracture management - Now you don't
Expected outcome:
Identify patterns of calcaneal fractures which are
amenable and suitable for percutaneous surgery
Apply appropriate techniques for closed reduction of
fracture
Explain the key points of percutaneous internal fixation
Evaluate the option of undertaking arthroscopically
assisted internal fixation
Lisa Taitsman
Versalius Lecture
Theatre
30
09:40
10:40
Discussion
Case Discussions; Hindfoot injuries (with coffee)
(Groups 2 & 4)
Expected outcome:
Outline management from simple to complex injury
patterns
Formulate a management explaining the importance of
the soft tissue envelope
Nima Heidari; James Stanley
Versalius Lecture
Theatre
60
16 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
09:40
10:40
Workshop (cadaver)
ORIF calcaneum (Groups 1 & 3)
Expected outcome:
Safely perform the extended lateral approach to the
calcaneus
Observe the peroneal tendons and attachment of the
peroneal sling to the peroneal tubercle CFL
Incise the STJ capsule and visualise the posterior facet
of the calcaneus
Explain the limitations of this approach
Describe the local anatomy with regards to other
approaches
Explain the trajectory of the screw into the
sustentaculum tali in order to fix the posterior facet
Pass a wire across the posterior facet into the
sustenculum. Pass through and cut down onto wire on
the medial side the see if placement is accurate.
Demonstrate the difficulty of visualising the CCJ
Window either side the of the peroneals in the distal
portion of the longitudinal limb of the incision.
Moderators/Faculty
Mark Jackson; James Livingstone;
Stephen Mitchell; Andrew Oppy; David
Stainsby; Lisa Taitsman; Claire Topliss;
Tom Wright
Location/Documents
Vesalius Wet Lab
Duration
60
0
Groups swap around
17 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
10:40
11:40
Discussion
Case Discussions; Hindfoot injuries (with coffee)
(Groups 1 & 3)
Expected outcome:
Outline management from simple to complex injury
patterns
Formulate a management explaining the importance of
the soft tissue envelope
Nima Heidari; James Stanley
Vesalius Lecture Theatre
60
10:40
11:40
Workshop (cadaver)
ORIF Calcaneum (Groups 2 & 4)
Expected outcome:
Safely perform the extended lateral approach to the
calcaneus
Observe the peroneal tendons and attachment of the
peroneal sling to the peroneal tubercle CFL
Incise the STJ capsule and visualise the posterior facet
of the calcaneus
Explain the limitations of this approach
Describe the local anatomy with regards to other
approaches
Explain the trajectory of the screw into the
sustentaculum tali in order to fix the posterior facet
Pass a wire across the posterior facet into the
sustenculum. Pass through and cut down onto wire on
the medial side the see if placement is accurate.
Demonstrate the difficulty of visualising the CCJ
Window either side the of the peroneals in the distal
portion of the longitudinal limb of the incision.
Mark Jackson; James Livingstone;
Stephen Mitchell; Andrew Oppy; David
Stainsby; Lisa Taitsman; Claire Topliss;
Tom Wright
Vesalius Wet Lab
60
11:40
12:15
MODERATOR:
Stephen Mitchell
35
18 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
11:40
12:15
Title
Lecture
Biomechanics: Stable midfoot segment
Expected outcome:
Formulate principles of the biomechanics of the foot
and ankle
Explain normal function and how it may be preserved
and restored
Justify how management of foot injuries should aim to
maintain and restore structural stability with respect to
balanced alignment and preserve controlled
coordinated intrinsic movements
Explain the importance of plantar aponeurosis and the
reverse windlass mechanism in controlling the
movements of the transverse tarsal joint
Moderators/Faculty
David Stainsby
Location/Documents
Duration
Vesalius Lecture Theatre
35
Vesalius Lecture Theatre
Breakout Area
55
Pattern of coordinated movements of the forefoot (and
related coordinated responses of hind-foot) to mid-foot
postural changes.
The effect of windlass mechanisms during ‘foot flat’ and
heel elevation postures
Adaptations to transverse ground slope
Refs: Hicks, Huson, Lewis, Winson et al.
12:15
13:10
Lunch
13:10
18:30
MODERATOR:
Lisa Taitsman
320
19 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
13:10
13:30
Title
Moderators/Faculty
Nima Heidari
Lecture
Injuries of the midfoot (Lisfranc)
Expected outcome:
Select appropriate imaging modalities for the
assessment of fracture pattern
Formulate an appropriate management plan
Relate this to the concept of the stable midfoot segment
Evaluate options for managing a delayed presentation
of lisfranc injury
Location/Documents
Duration
Vesalius Lecture Theatre
20
Vesalius Lecture Theatre
20
Formulate principles of how the function of the
transverse tarsal joints and the stable midfoot segment
dictate strategies for the management of complex
injuries to this anatomical zone
13:30
13:50
James Stanley
Lecture
Injuries of the midfoot (Chopart)
Expected outcome:
Select appropriate imaging modalities for the
assessment of fracture pattern
Formulate an appropriate management plan
Relate this to the concept of the stable midfoot segment
Evaluate surgical methods for reconstruction of the
Chopart joints
Formulate principles of how the function of the
transverse tarsal joints and the stable midfoot segment
dictate strategies for the management of complex
injuries to this anatomical zone
20 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
13:50
15:05
Mark Jackson; Lisa Taitsman
Discussion
Case discussions;
Midfoot/Forefoot injuries (with coffee)
(Groups 1 & 3)
Expected outcome:
Evaluate a variety of simple and traumatic injuries to
the midfoot and forefoot
Explain the concept of essential and nonessential joints
in the foot and bone specific fixation devices
13:50
15:05
Workshop (cadaver)
ORIF Cuboid/Navicular/Lisfranc (Groups 2 & 4)
Expected outcome:
Safely undertake approaches to the navicular cuboid
and the tarsometatarsal joints
Demonstrate approach to the midfoot
Compare single midline vs medial utility and over 3rd
MT
Identify the NV bundle
Window medial to EHL for medial column access
Window through EDB to access middle segment
TMTJs
Plate over 1st/2nd/3rd TMTJs
Look through the AM/AL approaches to the talar neck
to access the navicular
Extend the AL approach to talar neck in line with 4th
MT
Elevate EDB and visualise the cuboid, CCJ and TMTJs
Evaluate the roles of bone specific fixation plates,
bridge plating and arthrodesis
Nima Heidari; James Livingstone; Stephen
Mitchell; Andrew Oppy; David Stainsby;
James Stanley; Claire Topliss; Tom Wright
Location/Documents
Duration
Vesalius Lecture Theatre
75
Vesalius Wet Lab
75
21 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
Location/Documents
Duration
0
Groups swap around
15:05
16:20
Mark Jackson; Lisa Taitsman
Lecture
Case Discussions;
Midfoot/Forefoot Injuries (with coffee)
(Groups 2 & 4)
Expected outcome:
Evaluate a variety of simple and traumatic injuries to
the midfoot and forefoot
Explain the concept of essential and nonessential joints
in the foot and bone specific fixation devices
Vesalius Lecture Theatre
75
22 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
15:05
16:20
Workshop (cadaver)
ORIF Cuboid/Navicular/Lisfranc (Groups 1 & 3)
Expected outcome:
Safely undertake approaches to the navicular cuboid
and the tarsometatarsal joints
Demonstrate approach to the midfoot
Compare single midline vs medial utility and over 3rd
MT
Identify the NV bundle
Window medial to EHL for medial column access
Window through EDB to access middle segment
TMTJs
Plate over 1st/2nd/3rd TMTJs
Look through the AM/AL approaches to the talar neck
to access the navicular
Extend the AL approach to talar neck in line with 4th
MT
Elevate EDB and visualise the cuboid, CCJ and TMTJs
Evaluate the roles of bone specific fixation plates,
bridge plating and arthrodesis
Nima Heidari; James Livingstone; Stephen
Mitchell; Andrew Oppy; David Stainsby;
James Stanley; Claire Topliss; Tom Wright
Location/Documents
Vesalius Wet Lab
Duration
75
23 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Tuesday, 04 Apr 2017 (Day 2)
Start
End
Title
Moderators/Faculty
Location/Documents
16:20
17:10
Lecture
Below knee amputation - how it should be done
Expected outcome:
At the end of the session, participants will be able to:
Justify the importance of preserving length with a
combined orthoplastics approach
Select appropriate level for osteotomies
Design long posterior flaps and skew flaps
Divide muscles in each compartment at correct levels.
Bevel tibial osteotomy anteriorly and divide fibula 1-2
cm more proximally
Identify and control all vessels and divide all nerves
proximally to avoid problem neuromas.
Perform myodesis with gastrocnemius.
Close skin flaps in layers avoiding tension
Tom Wright
17:10
18:30
Discussion
Dirty Laundry - Faculty's worst cases
Expected outcome:
Critically appraise management strategies of specific
complex injuries
Apply a principles-based approach to the management
of difficult and salvage cases
Anticipate potential complications of primary and
salvage procedures
Define the role of soft tissue reconstruction in success
of limb salvage
Nima Heidari; Mark Jackson; James
Vesalius Lecture Theatre
Livingstone; Stephen Mitchell; Andrew
Oppy; David Stainsby; James Stanley; Lisa
Taitsman; Claire Topliss; Tom Wright
Vesalius Lectue Theatre
Duration
50
80
24 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Wednesday, 05 Apr 2017 (Day 3)
Start
End
Title
Moderators/Faculty
08:20
08:30
Other
Coffee & questions
08:30
10:20
MODERATOR:
James Livingstone
08:30
09:05
Lecture
Biomechanics: Normal walking and running
Expected outcome:
Formulate principles of the biomechanics of the foot
and ankle
Explain normal function and how it may be preserved
and restored
Justify how management of foot injuries should aim to
maintain and restore structural stability with respect to
balanced alignment and preserve controlled
coordinated intrinsic movements
Explain the importance of plantar aponeurosis and the
reverse windlass mechanism in controlling the
movements of the transverse tarsal joint
David Stainsby
Location/Documents
Vesalius Lecture Theatre
Duration
10
110
Vesalius Lecture Theatre
35
The foot as a longitudinal balanced cantilever with a
lateral balance mechanism
Gait cycles: coordinated intrinsic movements of the
foot, leg segments and pelvis
Brief mention: Other conditions: HV, flat and cavus feet
Effects of breakdown of tie-bar system
Consequences of muscle imbalance (weakness,
contracture).
25 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Wednesday, 05 Apr 2017 (Day 3)
Start
End
09:05
09:25
Title
Lecture
Compartment Syndrome in the foot
Expected outcome:
Describe foot compartment syndrome
Recognise it in the clinical setting
Evaluate the options for decompression
Explain the current controversy surrounding the
diagnosis and management
Moderators/Faculty
Lisa Taitsman
Location/Documents
Vesalius Lecture Theatre
Duration
20
26 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Wednesday, 05 Apr 2017 (Day 3)
Start
End
Title
09:25
10:20
Lecture
Still Stumped?
VA foot, VA ankle, pilon plates, Ex-fix, including
instruments
(with coffee)
Expected outcome:
Perform an application of external fixation spanning the
ankle joint to resuscitate the soft tissues and stage
management of complex fractures
Explain the importance of the placement of
transcutaneous fixation components outside the zone
of surgery
Insert proximal pins (5mm) into the tibial crest and
outside zone of surgery
Insert through and through calcaneal Denham pin
(centrally threaded Steinman pin)
1st MT 4mm ½ pin
5th/4th MT ¾ mm pin
A-frame construct
Stirrup under the heel for protection of soft tissues
Moderators/Faculty
Location/Documents
Nima Heidari; Mark Jackson; James
Vesalius Wet Lab
Livingstone; Stephen Mitchell; Andrew
Breakout Room
Oppy; David Stainsby; James Stanley; Lisa
Taitsman; Tom Wright
Duration
55
Alter frame config to accommodate definitive fixation
Insert posterior proximal pin for IM nailing access
Insert posterior calc pin to leave hindfoot nail corridor
10:20
12:35
MODERATOR:
Mark Jackson
135
27 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Wednesday, 05 Apr 2017 (Day 3)
Start
End
Title
Moderators/Faculty
Location/Documents
10:20
10:40
James Livingstone
Lecture
Fine wire fixation in the foot & ankle
Expected outcome:
Describe how to use a FireWire circular frame to treat a
pilon fracture
Outline indications for the use of fine wire fixators
elsewhere in the foot and ankle
Identify safe corridors for insertion of fine wires in
construction of a circular frame
Vesalius Lecture Theatre
20
10:40
11:05
Andrew Oppy
Lecture
CRPS
Expected outcome:
Outline the aetiology of CRPS
Recognise and diagnose CRPS
Define the role of surgery and the multidisciplinary team
approach to the management of CRPS
Vesalius Lecture Theatre
25
11:05
12:25
Discussion
The foot & ankle trauma Unit
Expected outcome:
Identify management priorities of a variety of acute
traumatic foot and ankle injuries
Plan a management strategy with timelines
Select appropriate fixation techniques and surgical
approaches
Define staged management protocol explaining need
for timely soft tissue reconstruction
Nima Heidari; Mark Jackson; James
Vesalius Lecture Theatre
Livingstone; Stephen Mitchell; Andrew
Oppy; David Stainsby; James Stanley; Lisa
Taitsman; Tom Wright
80
12:25
12:35
Lecture
Summary & Feedback
Stephen Mitchell
10
Vesalius Lecture Theatre
Duration
28 / 29
AOTrauma Masters Course—Foot & Ankle Reconstruction
03 Apr 2017 - 05 Apr 2017, Bristol, United Kingdom
Wednesday, 05 Apr 2017 (Day 3)
Start
End
12:35
13:00
Title
Close of course, evaluation and light lunch
Moderators/Faculty
Location/Documents
Vesalius Lecture Theatre
Breakout Area
Duration
25
29 / 29