We describe an inexpensive method of producing a reinforced articulating cement spacer using a commercially available hip cement mould. We have a cohort of 15 consecutive patients in whom this novel cement spacer has been used. All patients were able to at least partially weight bear and none of the spacers fractured. Thirteen have been explanted at second stage operation after a minimum of eight weeks in situ. Two patients have been unable to undergo a second stage due to unrelated death and medical problems precluding further surgery. The articulating cement spacer described is produced using a technique that is simple, reproducible and allows a reinforced spacer to be created inexpensively without the need for special equipment.

Os intermetatarseum is the rarest accessory bone of the foot. It is usually found between 1st and the 2nd metatarsal bases arising typically from the base of the 2nd metatarsal. Only a few symptomatic cases have been reported in the literature, which were either unilateral or bilateral and radiographically they were of different shapes and sizes. We present a large, bilaterally symmetrical and unusual variant of os intermetatarseum. To our knowledge, such large, bilaterally symmetrical, fully formed os intermetatarseum, fusing to both metatarsals has not been described before. The case report also describes the surgical anatomy during the excision of os intermetatarseum and review of the literature to date. How to cite this article Rachha R, Gorva A. Os Intermetatarseum revisited: A Case Report of Rare Variant and Review of Literature. J Foot Ankle Surg (Asia-Pacific) 2015;2(1): 47-50.

Ann R Coll Surg Engl 2009; 91: 711-717 716Coren et al. 1 argue that human vision favours horizontal or vertical lines rather than oblique lines. Thus, rather than use the standard anterior-posterior projected image of the hip, we routinely rotate the intensifier image so that the guide wire appears to be passing in a vertical direction. By rotating the image (Fig. 1) in this way, it becomes significantly easier to visualise the projected direction of the guide wire and, in doing so, ensure its accurate final placement thereby minimising possible complications. The aspiration and injection of joints is a valuable diagnostic and therapeutic procedure. The palpation of anatomical landmarks immediately prior to injection can desterilise the field. We present a simple method for improving 'no-touch' technique, although we acknowledge that this technique is not original. The injection site is palpated before preparing a sterile field. The tip of the ensheathed needle is gently pressed into the planned injection site and held for several seconds. On removal, the tip of the sheath leaves a 'bull's eye' impression in the skin, which remains visible for several minutes (Fig. 1). Skin preparation and joint injection can then proceed without the need for further palpation.As with many hospitals, we recently moved to self-adhesive operative drapes. We find the plastic towel clips for these drapes ineffective and describe a head drape technique which avoids their use. Two drapes are placed under the head with the upper drape positioned upside down and the adhesive strip (arrow) away from the head (Fig 1a). The skin is prepared and the head wrapped with the upper drape (Fig 1b). The adhesive strip (*) is exposed, fixed onto the patients forehead over the edges of the head drape (Fig 1c), and laterally onto the body drape (Fig 1d).Intra-operative scattering of cement fragments during cement removal with osteotomes in revision arthroplasty is common and potentially harmful.

Aim The scarf osteotomy, as popularized by Barouk, is a versatile osteotomy for the correction of moderate and severe hallux valgus deformity. However, this technique requires extensive exposure, fixation, and increased operative time, and is technically demanding. We describe and present our results of a short scarf osteotomy (SSO), which retains all the cuts of a standard scarf but requires a reduced exposure, less metalwork, less operating time, and is more economical. Materials and methods All patients who underwent SSO between January 2010 and December 2012 with minimum follow-up of 12 months were eligible for the study. Preoperative, intraoperative, and postoperative radiographs were available for radiological assessment. Results In this study, 84 patients and 94 feet were included; 90% of patients were satisfied overall, with 83% of patients recommending this surgery to a friend. The hallux valgus angle improved from a preoperative mean of 30.89° (17.4—46.8) to 12° (4—30) postoperatively (p = 0.0001). The intermetatarsal angle improved from a preoperative mean of 15.05° (10.3—21.1) to 7.14° (4—15.1) postoperatively (p = 0.0001). The average sesamoid coverage improved from grade 2.18 (1—3) preoperatively to 0.57 (0—2) postoperatively (p = 0.0001). The average American Orthopedic Foot and Ankle Score improved from 51.26 (32—88) preoperatively to 91.1 (72—100) postoperatively (p = 0.0001). Conclusion We believe that this osteotomy is a novel procedure producing good to excellent results in most cases of hallux valgus. Biologically, the decreased exposure should improve healing and reduce the risk of avascular necrosis. We strongly recommend this osteotomy for most cases of hallux valgus surgery. How to cite this article Dalal R, Rachha R, Leonard D, Chourasia A, Javed S. Short Scarf Osteotomy for Hallux Valgus: Short-term and Medium-term Results. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):14-18.

Hallux varus is a much rarer deformity in clinical practice than hallux valgus. It can be congenital, associated with inflammatory arthropathy or iatrogenic due to overcorrection in hallux valgus surgery. There have been many treatments suggested but no gold standard has been found. We will describe a simple surgical procedure involving the scarf osteotomy to reverse the overcorrection of hallux valgus. How to cite this article Dalal RB, Plastow RGE, Rachha R. Reverse Scarf Osteotomy for Hallux Varus following Surgery for Hallux Valgus. J Foot Ankle Surg (Asia-Pacific) 2014;1(2):52-54.