This presentation including each medical illustration, is intended for
use by The Law Office of Jeffery Davis. This presen...
PART 1
Client’s Initial Injury
1/24/05
Xray showing broken 4th and 5th toes
1/24/05
• Illustration
1/27/05
Foot is casted after fracture
02/08/05
4 weeks post fracture
foot is immobilized with
CAM walker to promote healing
03/02/05
8 weeks post fracture
CAM w...
04/25/05
14 weeks after accident
Radiologic exam reveals
bone callus formation
and progressive
trabeculation across the
fr...
04/25/05
14 weeks after accident
Radiologic exam reveals
bone callus formation
and progressive
trabeculation across the
fr...
04/25/05
14 weeks after accident
Radiologic exam reveals
bone callus formation
and progressive
trabeculation across the
fr...
07/05/05
MRI report was read and noted in
chart. “No significant osseous or
tendonous pathology noted pain and
swelling mo...
PART 2
Client’s Secondary Injuries
11/22/05
Consult with Dr.
Client was told he needed surgery on
1st
, 4th
, and 5th
toes.
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
02/16/06
Surgery: 1st, 4th, 5th toes
BIG TOE (1st
):
Incision was made over the 1st
joint.
Bone was drilled at the center ...
04/10/06
SURGERY HAS FAILED
In his 4/10/06 office visit with Dr., Client is told
the surgery will need to be revised and t...
05/26/06
Xray demonstrates
deformities caused
by joint implant and
other complications
Hammertoe
is
exacerbated
Implant is...
05/26/06
Xray demonstrates
deformities caused
by joint implant and
other complications
Hammertoe
is
exacerbated
Implant is...
07/24/06
2nd Surgery
Right 5th
joint opened, the failed
implant is removed, more bone is cut
away and a smaller implant is...
07/24/06
2nd Surgery
Right 5th
joint opened, the failed
implant is removed, more bone is cut
away and a smaller implant is...
07/24/06
2nd Surgery
Right 1st
joint re-opened , bone spurs
were cut from the metatarsal head
07/24/06
2nd Surgery
Right 1st
joint re-opened , bone spurs
were cut from the metatarsal head
07/24/06
2nd Surgery
An infection at the nail boarder was
cut down to the matrix
06/07/07
SECOND SURGERY HAS FAILED
Client has new complaints at this follow up visit with Dr.:
Pain at inner ankle
Cannot ...
06/13/07
MRI
New Findings:
Partial tendon tear
tenosynovitis around 1st
toe
06/29/07
3rd
Surgery
Hemi implant is removed. More bone
is cut away and a total joint implant
was cemented into place.
out...
06/29/07
3rd
Surgery
Both scar tissue and a neuroma was
removed from around the nerve at the
5th
toe
08/21/07
THIRD SURGERY HAS FAILED
Client has new complaints at his follow up visit with Dr.:
Increased pain over 1st
joint...
detail from office note
04/02/08
MRI
New tendonopathies in Client’s
right ankle are diagnosed.
05/02/08
4th Surgery
LITTLE TOE (5TH).
Boney overgrowth was cut away from
around the implant.
BIG TOE (1st):
Total implant...
05/02/08
4th Surgery
LITTLE TOE (5TH).
Boney overgrowth was cut away from
around the implant.
BIG TOE (1st):
Total implant...
05/02/08
4th Surgery
LITTLE TOE (5TH).
Boney overgrowth was cut away from
around the implant.
BIG TOE (1st):
Total implant...
05/02/08
4th Surgery
LITTLE TOE (5TH).
Boney overgrowth was cut away from
around the implant.
BIG TOE (1st):
Total implant...
05/02/08
4th Surgery
LITTLE TOE (5TH).
Boney overgrowth was cut away from
around the implant.
BIG TOE (1st):
Total implant...
05/02/08
4th Surgery
LITTLE TOE (5TH).
Boney overgrowth was cut away from
around the implant.
BIG TOE (1st):
Total implant...
05/02/08
4th Surgery
INNER ANKLE:
Skin was incised and a tendon
graft was installed to prevent
radiating pain at arch
Before
After
After
Silacone Implant
Implant removal
Silacone Implant
Implant removal
Removal of condyle
Removal of neuroma
Hemi implant...
This presentation including each medical illustration, is intended for
use by The Law Office of Jeffery Davis. This presen...
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  1. 1. This presentation including each medical illustration, is intended for use by The Law Office of Jeffery Davis. This presentation is the sole property of Art for Law & Medicine, Inc. The copyrighted artwork may NOT be reproduced in any way. Any unauthorized review, use, duplication, sharing, downloading, disclosure or distribution is strictly prohibited.
  2. 2. PART 1 Client’s Initial Injury
  3. 3. 1/24/05 Xray showing broken 4th and 5th toes
  4. 4. 1/24/05 • Illustration
  5. 5. 1/27/05 Foot is casted after fracture
  6. 6. 02/08/05 4 weeks post fracture foot is immobilized with CAM walker to promote healing 03/02/05 8 weeks post fracture CAM walker continued, fracture still well defined 1/27/05 Foot is casted after fracture
  7. 7. 04/25/05 14 weeks after accident Radiologic exam reveals bone callus formation and progressive trabeculation across the fracture site consistent with normal bone healing. 03/28/05 10 weeks after accident Radiologic exam reveals evidence of bone callust formation and trabeculation across the fracture site consistent with delayed union.
  8. 8. 04/25/05 14 weeks after accident Radiologic exam reveals bone callus formation and progressive trabeculation across the fracture site consistent with normal bone healing.
  9. 9. 04/25/05 14 weeks after accident Radiologic exam reveals bone callus formation and progressive trabeculation across the fracture site consistent with normal bone healing.
  10. 10. 07/05/05 MRI report was read and noted in chart. “No significant osseous or tendonous pathology noted pain and swelling mostly soft tissue with fracture 5th toe healing. 6/29/05 232 individual MRI images of right foot were obtained. 10/06/05 Radiologic exam reveals normal bone healing. Dr. discusses conservative treatments and possible surgery.
  11. 11. PART 2 Client’s Secondary Injuries
  12. 12. 11/22/05 Consult with Dr. Client was told he needed surgery on 1st , 4th , and 5th toes.
  13. 13. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op x- ray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  14. 14. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op x- ray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  15. 15. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op xray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  16. 16. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op xray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  17. 17. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op xray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  18. 18. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op xray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  19. 19. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op xray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  20. 20. 02/16/06 Surgery: 1st, 4th, 5th toes BIG TOE (1st ): Incision was made over the 1st joint. Bone was drilled at the center to open a space for the implant. See post op xray. LITTLE TOE (5th ): Incision made over 5th joint revealed healing fracture. Bone was cut away from the head of the metatarsal and the base of the phalanx. A Silastic implant was installed. 4TH TOE: Incision over capsule and periosteum revealed “4th metatarsal head has healthy good cartilage” that demonstrated “gliding motion” and had “good range of motion”
  21. 21. 04/10/06 SURGERY HAS FAILED In his 4/10/06 office visit with Dr., Client is told the surgery will need to be revised and that he has a new problem that will require surgery. detail from office note
  22. 22. 05/26/06 Xray demonstrates deformities caused by joint implant and other complications Hammertoe is exacerbated Implant is too large. Hammertoe Infection at nail boarder
  23. 23. 05/26/06 Xray demonstrates deformities caused by joint implant and other complications Hammertoe is exacerbated Implant is too large. Hammertoe Infection at nail boarder
  24. 24. 07/24/06 2nd Surgery Right 5th joint opened, the failed implant is removed, more bone is cut away and a smaller implant is installed
  25. 25. 07/24/06 2nd Surgery Right 5th joint opened, the failed implant is removed, more bone is cut away and a smaller implant is installed
  26. 26. 07/24/06 2nd Surgery Right 1st joint re-opened , bone spurs were cut from the metatarsal head
  27. 27. 07/24/06 2nd Surgery Right 1st joint re-opened , bone spurs were cut from the metatarsal head
  28. 28. 07/24/06 2nd Surgery An infection at the nail boarder was cut down to the matrix
  29. 29. 06/07/07 SECOND SURGERY HAS FAILED Client has new complaints at this follow up visit with Dr.: Pain at inner ankle Cannot bend first toe Cannot bear weight on 5th toe detail from office note
  30. 30. 06/13/07 MRI New Findings: Partial tendon tear tenosynovitis around 1st toe
  31. 31. 06/29/07 3rd Surgery Hemi implant is removed. More bone is cut away and a total joint implant was cemented into place. out in
  32. 32. 06/29/07 3rd Surgery Both scar tissue and a neuroma was removed from around the nerve at the 5th toe
  33. 33. 08/21/07 THIRD SURGERY HAS FAILED Client has new complaints at his follow up visit with Dr.: Increased pain over 1st joint Allergic reaction to implant with Staph infection office notedetail from
  34. 34. detail from office note 04/02/08 MRI New tendonopathies in Client’s right ankle are diagnosed.
  35. 35. 05/02/08 4th Surgery LITTLE TOE (5TH). Boney overgrowth was cut away from around the implant. BIG TOE (1st): Total implant was removed from the first toe. The joint was fused with bone chips and cement. It was fixated externally with rods and bone screws inserted through the skin. ANKLE: An athroereisis was installed through incision at sinus tarsi. This bone screw was used to immobilize part of the ankle joint.
  36. 36. 05/02/08 4th Surgery LITTLE TOE (5TH). Boney overgrowth was cut away from around the implant. BIG TOE (1st): Total implant was removed from the first toe. The joint was fused with bone chips and cement. It was fixated externally with rods and bone screws inserted through the skin. ANKLE: An athroereisis was installed through incision at sinus tarsi. This bone screw was used to immobilize part of the ankle joint.
  37. 37. 05/02/08 4th Surgery LITTLE TOE (5TH). Boney overgrowth was cut away from around the implant. BIG TOE (1st): Total implant was removed from the first toe. The joint was fused with bone chips and cement. It was fixated externally with rods and bone screws inserted through the skin. ANKLE: An athroereisis was installed through incision at sinus tarsi. This bone screw was used to immobilize part of the ankle joint.
  38. 38. 05/02/08 4th Surgery LITTLE TOE (5TH). Boney overgrowth was cut away from around the implant. BIG TOE (1st): Total implant was removed from the first toe. The joint was fused with bone chips and cement. It was fixated externally with rods and bone screws inserted through the skin. ANKLE: An athroereisis was installed through incision at sinus tarsi. This bone screw was used to immobilize part of the ankle joint.
  39. 39. 05/02/08 4th Surgery LITTLE TOE (5TH). Boney overgrowth was cut away from around the implant. BIG TOE (1st): Total implant was removed from the first toe. The joint was fused with bone chips and cement. It was fixated externally with rods and bone screws inserted through the skin. ANKLE: An athroereisis was installed through incision at sinus tarsi. This bone screw was used to immobilize part of the ankle joint.
  40. 40. 05/02/08 4th Surgery LITTLE TOE (5TH). Boney overgrowth was cut away from around the implant. BIG TOE (1st): Total implant was removed from the first toe. The joint was fused with bone chips and cement. It was fixated externally with rods and bone screws inserted through the skin. ANKLE: An athroereisis was installed through incision at sinus tarsi. This bone screw was used to immobilize part of the ankle joint. (continued)
  41. 41. 05/02/08 4th Surgery INNER ANKLE: Skin was incised and a tendon graft was installed to prevent radiating pain at arch
  42. 42. Before
  43. 43. After
  44. 44. After Silacone Implant Implant removal Silacone Implant Implant removal Removal of condyle Removal of neuroma Hemi implant Hemi implant removal Total joint implant Removal of ostephytes Total joint removal Fusion Arthroereisis implant subtalar joint
  45. 45. This presentation including each medical illustration, is intended for use by The Law Office of Jeffery Davis. This presentation is the sole property of Art for Law & Medicine, Inc. The copyrighted artwork may NOT be reproduced in any way. Any unauthorized review, use, duplication, sharing, downloading, disclosure or distribution is strictly prohibited.

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