For those listeners less familiar or just learning the percutaneous technique, what tips and tricks do you have to keep the burr away from the skin? As an example, when you're performing the dorsal cortex osteotomy, what do you do with your hand and the burr shaft to avoid the burr contacting the more plantar skin and then vice versa for the plantar cortex? What do you do in order to avoid the contact with the skin?

The issue is not preventing the contact with the skin because the burr will always remain in contact with the skin.

It's a matter of how much stress that burr is putting against the skin.

So one of the biggest mistakes I see in, for instance, in labs is for surgeons to translate the burr dorsal if they need to cut the dorsal cortex or plantar.

And what that is doing is you're simply just putting pressure in one direction or the other against the skin, which is why most surgeons will end up with an incision which doesn't really look like a poke hole, but rather a vertical incision of five, six millimeters.

So you have to keep in mind that the movement is rotatory.

It's not a translation.

Why is it okay to allow the patients to transition to a sneaker at four weeks when union is not observed for three months and full bone reformation may not happen for a year?