{"text":"Miss Madeley \nNGH \u2018 : \n09\/02\/2018 ! \nRight 1st MTPJ Fusion \nJ Madeley \nAssnstant l Arnabel Hayward \n: 'naesthx \u2018 \n\u2018Patient supine, prep ard drape. \nDorsal:longitudinal incision over 1% MTPJ. Dorsal cutaneous nerve protected ang incision taken down medial border to EHL to bone. \n\u2018Joint examined \u2014 large area of cartilage loss on metatarsal head. \nMTPJ reamers used to prepare jaint surfaces to congruent bleedlng bone \nJoint positioned and held with temporary K-wires. \nOnce desired comection achieved joint compressed with 1 x 4mm Asms screws and secured with a Variax 6-hole dorsal plate. \nFinal position clinically and radiologically good with 10 degrees valgus, neutral rotation and dorsifiexed such that the pulp of the toe rested on the \n\u2018ground\u2019 on simutated weight beanng \n~ \nWashout \nClosure 2.0'P6Iysorb. 3.0 Vieryl \u2018 \nPost-op \nElevate, analgesia, ob's \nOral hydration and early mobnltsatlon for VTE prophylaxis \n. HWB 6\/52 \nNurse led clinic 10-14.days, wourid check. : v \nOPD 6\/52, XOA and start FWB. \n\u00a5 \n. Miss N J Madeley\/ \nAddenda: . \n[ \nKilsyth Medical Partnership \nKilsyth Communily Health Centra \nAirdrie Road \nKitsyth \nG65 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