The Foot

Kaj Klaue completed his Federal Diploma of Human Medicine at CHUV Lausanne in 1978 and subsequently gained his PhD thesis from the University of Basle. Dr. Klaue began his studies of the locomotor system as a research fellow at the Laboratory for Experimental Surgery, Davos, under the direction of S.M. Perren, performing multiple projects in vitro and in vivo, mainly on sheep. The rational context linking mechanical evidence with the biological response has always been dominant in his experimental and later clinical work. Dr. Klaue’s early work involved morphological analysis of the hip joint and optimization of reorientation osteotomies of the acetabulum, but his interest then turned to foot and ankle surgery. His fields of research have included development of a computerized 3-D imaging system for diagnostic purposes in orthopaedics and pre-operative simulation of corrective means, development of fixation plates, and improvement of foot and ankle reconstruction techniques; he is the holder of 15 patents. From 1993 to 2006 Dr. Klaue was a member of the Foot and Ankle Expert Group of the AO Technical Commission (AOFAEG). He currently works as an orthopaedic surgeon at the Clinica Luganese, Lugano, Switzerland. Dr. Klaue is a member of the editorial boards of Foot and Ankle Surgery and Revue de Médecine et Chirurgie du Pied.

ANAMNESIS: Timetable of disorder (progression, trauma, previous surgery, chronology).- Type of disorder.- Localization.- Activity dependence.- Barometric dependence.- Personal anamnesis (other pathologies and surgery). CLINICAL EXAMINATION: Independent walk, gait.- Static (standing on the cube and podoscope).- Passive joint mobility (sitting on the cube).- Active joint mobility.- Joint stability.- Visualization and palpation. RADIOLOGICAL SCREENING: Conventional radiographs.- CT.- MRI. SURGICAL CORRECTIONS: Reorientation of the upper ankle joint.- Reorientation of the lateral malleolus.- Osteochondroplasty of the talus.- Lateralisation of the hindfoot axis.- Reorientation arthrodesis of the subtalar joint.- Ligamentous reconstruction of the ligaments about the upper ankle joint.- Removal of impingements at the upper ankle joint.- Removal of impingements at the lower ankle joint.- Reorientation of the lower ankle joint.- Functional extension of the hindfoot.- Tibialis anterior tendon transfer on the lateral dorsum of the foot.- Flexor digitorum longus tendon transfer onto the first cuneiform.- Fibularis longus tendon transfer onto the fifth metatarsus.- Flexor hallucis longus tendon transfer on the fifth metatarsus.- Reorientation of the first tarso-metatarsal joint.- Reorientation of the lesser metatarsal heads.- Functional correction of the toes.