Special report Highlights of the Eighteenth Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society, Traverse City, Michigan, 12 – 14 July 2002 q E. Trepman, L.D. Lutter, C.L. Saltzman American Orthopaedic Foot and Ankle Society, Seattle, WA, USA 1. Introduction The Eighteenth Annual Summer Meeting of the Amer- ican Orthopaedic Foot and Ankle Society (AOFAS) was held 12–14 July 2002 at the Grand Traverse Resort in Traverse City, Michigan. There were 348 registrants in attendance, including 26 individuals from 11 countries outside the United States. 2. Clinical symposia I. Diabetic foot surgery. Exostectomy in the deformed diabetic foot is indicated for a bony prominence that causes an ulcer that does not respond to non-operative treatment [1]. In the diabetic ankle and hindfoot, muscle balancing may include a gastrocnemius reces- sion, peroneus longus lengthening, or transfer of the extensor digitorum longus to the midfoot [2]. External fixation for ankle arthrodesis in the diabetic patient may include placement of frame components at the tibia, calcaneus, and forefoot that allow access to the soft tissues [3]. Arthrodesis of the Charcot hindfoot or midfoot is indicated for a deformity that cannot be braced, unstable deformity, recurrent ulceration, or persistent osteomyelitis, and may include a closing wedge osteotomy and plantar plate fixation [4]. Fore- foot amputation options include ray resection and transmetatarsal amputation, and gastrocsoleus lengthening may decrease the risk of late ulceration caused by an equinus contracture [5]. II. New sports techniques. Posterior ankle arthroscopy may be indicated for posterior ankle impingement, flexor hallucis longus tenosynovitis, painful os trigonum, posterior osteochondral lesion, and subtalar joint problems [6]. In securing a tendon transfer in a bony tunnel, such as with lateral ankle ligament reconstruc- tion, a bioabsorbable interference screw may provide rigid fixation of the tendon graft to the bone [7]. Arthroscopic thermal capsular shrinkage with post- operative immobilization may be successful in achiev- ing lateral ankle stability in patients with instability [8]. Evaluation of the hallux metatarsophalangeal (MP) hyperextension injury (‘turf toe’) may demonstrate laxity with dorsal drawer, proximal position of the sesamoids, or diastasis of a bipartite sesamoid; the goals of treatment include restoration of anatomy with either immobilization or surgery [9]. III. Practice development. Although fulfilling, professional life is demanding and insatiable; finding a balance of professional and personal priorities may be achieved by creating a ‘professional firewall’ to protect against all- encompassing work activities [10]. In group practice, prudent selection of an associate includes assessment of the candidate’s goals and references; dissolving a professional relationship requires documentation, legal advice, and professional etiquette [11]. Hiring and maintaining good employees may be facilitated with attention to the interview process, background checks, teamwork and staff morale, the work environment, physician behavior, and conflict resolution [12]. A solo practice may afford greater control of overhead, staffing, and personal time, and may be facilitated by outsourcing and sharing costly services [13]. A decision to move to a new practice should follow a careful evaluation of the current and new practice situations, referral patterns, career time-frame, and advantages and disadvantages of the move [14]. doi:10.1016/S1268-7731(03)00013-4 Foot and Ankle Surgery 9 (2003) 67–76 www.elsevier.com/locate/fas q Publication does not constitute endorsement of content or validation of conclusions. Comparisons should be made with caution because statistical significance might not have been noted in the abstracts published in the conference program. Correspondence: Jessica Lutter, Managing Editor, Foot & Ankle International, 265 Brimhall Street, St. Paul, MN, 55105, USA.