Christopher Miller, MD, MHS, FAAOS @BostonFootAnkle Twitter profile

Pinned Tweet

Christopher Miller, MD, MHS, FAAOS

2 years

This is how a total ankle replacement is performed in case anyone is interested. This is the @strykerfa #InBone implant with prophecy guide jigs. #orthotwitter #anklereplacement #arthritis

13

44

308

Last Seen Profiles

@voidlessshit

@rscarrera27

@AlsubaieM

@barnett_la55754

@dryade

@teki_toy

@richmond_bball

@fapals

@The_BigHelmet

@gaurimahulikar

@CuteLilBottom

@istri_binall

@Swannysblive

@CSHL

@bokeplokalmalam

@A350Blog

@raycra_nov

@safy757

@sozebeats

@eclipsehwi

@tpy8CzeoQVRhCZr

@yazaksamet

@KIZILTIM_

@SRonde13792

@TeamBesiege

@stw_pdg

@r3kapig

@stwmaniax

@SoundExchange

@JADSTUDIOSYT

@pong32

@voidlessshit

@FUNPADEM

@ApHollin

@SekAI_AIart

@t_czer_jea

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

@AlextheDPT @schulte_ss Seriously. Some women can barely walk at all after a regular delivery. Can’t image after c section. If I did that on an ortho floor I’d have the nurses reporting me to the admin. How is this tolerated on OB units?

31

21

906

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

When do surgeons stop losing sleep the night before a tough case? It happens less now and the bar for a “tough case” gets higher with experience. I’ve mostly stopped worrying about being able to DO the case. But I still lose sleep over the outcome long term #OrthoTwitter

36

19

336

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

@DGlaucomflecken Our foot and ankle fellow was redeployed to a covid ICU acting as an intern essentially. All of his patients had podus boots. He held signs up to RNs in the room asking them to keep the feet in neutral to prevent equinus contractures. ICU docs do not see the long term problems.

8

4

230

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

@AlanPlotzker @DGlaucomflecken We just photoshop those into the xrays afterwards. Don’t be fooled. It is 100% superglue.

1

2

210

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

20s M parkour enthusiast. Injury and pain at the right foot. Unable to walk. Xrays read as normal at local UC. Posted with permission. Took a while to block out the face. 1/x #orthotwitter

18

42

196

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Percutaneous reduction for calcaneal fracture decrease wound risks while restoring the shape. High risk of subtalar arthritis regardless of treatment selected even in the best of hands. #orthotwitter 1/x

19

36

185

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

10 months

If there is a cooler post op X-ray than this I don’t know it… #orthotwitter

17

11

169

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

26 year old male, now 3 years out from a custom 3D printed total talus replacement for talar body extrusion. Not recovered from scene . Back at work with normal range of motion. Better than a pantalar fusion at such a young age. #Orthopedics #MedTwitter #3Dprinting

12

26

166

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

40s woman with ankle arthritis in medial gutter and slight supramalleolar varus deformity. Failed scope/brostrom. Elected for double osteotomy (SMO and Lateralizing calc) with deltoid peel. #orthotwitter 1/x

5

27

164

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

10 months

No X-rays needed! #orthotwitter

10

9

161

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

This is a surgical amputation knife. I think this will be my next bladesmithing project. Not for actual use of course. This is throwback to our surgical forefathers who could cut off a leg in mere minutes. They had to be fast without anesthesia... #orthotwitter #orthoblacksmith

23

12

145

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

My contribution to orthopaedic cement art work: Jaba the Hutt Lots of hemis this weekend. #orthotwitter

7

6

145

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

It’s almost like it was designed to fit perfectly! #3dprinting #talus #osteonecrosis #orthotwitter

7

8

136

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Watching residents master surgical skills is one of the best parts of the job @harvardortho

4

7

134

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Two weeks out. Wound healed and starting some gentle ROM. The arthritis pain is completely gone and he was off narcotics POD 2. #totalankle #orthotwitter

6

127

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Painful peroneal tendinitis and split tears. You can see the tendon has a large nodule. This was just proximal to the subdivision of the sheaths at the peroneal tubercle. He was unable to invert his foot because the nodule would not pass into the smaller sheath. #orthotwitter 1/

6

30

126

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

6 months

More perc calc ORIF! Further limits wound concerns. Restore the shape. Limit wound complications. #orthotwitter

13

12

124

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

I learned this stitch from our plastic surgeon and call it the “running reverse.” I use a #2 prolene suture and run the big throws first. Then come back with the small throws. Tie an air knot. 1/3 #orthotwitter

7

12

117

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Anatomic and Radiographic Safe Zone for Posterior Malleolar Screw Placement - An easy intra-operative measure to use that can avoid placing hardware in the posterior syndesmosis.

4

25

114

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

The #MIS Zadek osteotomy for insertional #Achilles #tendinitis . This patient is 6 weeks postop and has 0 pain. Returning to work as house cleaner next week. #orthotwitter Thoughts? @pmangoneMD @NazarianLab @Ortho_BIDMC @FootAndAnkleMD @GlennShiMD @TheFootAnkleDoc @orthovulcano

18

15

113

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

@DGlaucomflecken They are understandably focused on the acute care issues. Maybe rooms for multi speciality initiatives help out and address these less acute problems?

4

0

110

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

10 months

#MIS #calcaneal fx ORIF…making calc fxs fun again. #orthotwitter

4

8

114

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

10 months

Patient with severe metatarsalgia and plantar fasciitis. Any guesses on possible treatment here? #orthotwitter

30

12

105

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

Ankle dislocation during soccer. Self reduced. Had to osteotomize the fibula to get in. Reduced major lateral piece and then elevated a small osteochondral fragment and rafted it with the k-wire. Now back to running and sports. Sore at end of day.

13

17

106

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Ortho indoctrination continues for my scribe. Working on suturing and instrument ties. She’s going to crush it in medschool. #orthotwitter #medtwitter

1

3

106

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Coban can be a third hand to keep pressure on a clamp or distractor. #orthotwitter

11

7

103

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

i feel this....the muscle bounce.... 😬

Irineu Loturco PhD

@IrineuLoturco

6 years

A very impressive recording of the exact moment when an elite sprinter had an acute and complete rupture of the Achilles tendon. Pay attention to the "boom".

324

4K

6K

10

28

98

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

We made the cover! And I even initialed it for everyone too. You’re welcome. #orthotwitter MIS foot and ankle surgery. A primer for orthopaedic surgeons. @Ortho_BIDMC

9

3

99

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

8 months

Ankle fusion (Confirmed on CT). Patients can still have more "ankle" motion than you may expect. This patient has sag motion of about 30 deg through the TN and subtalar joints. Also explains why adjacent joint OA will happen over time due to the abnormal motion. #orthotwitter

8

15

100

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

20 years after a 5th metatarsal fracture which healed without surgery. He reports no pain at this partial synosostosis. In 8 years I have never fixed one of these fractures. #orthotwitter Thoughts? @DrAdamBitterman @GlennShiMD @FootAndAnkleMD @AGianakosDO

21

10

100

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

What is this instrument called? #orthotwitter

92

6

97

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Working a TTC and pantalar fusions last week and wanted to share a tip on using the spider to help position the leg. 1. Hang the leg from the strap while putting in the PA screws. Easy imaging and no struggle to hold and drill. #orthotwitter 1/2

7

5

94

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

This is the resected tibial and talar surfaces removed during #anklereplacement . The congruity is quite satisfying. #orthotwitter

3

10

92

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

6 months

Neuropathy sucks #orthotwitter

15

5

88

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Follow up on a prior case. 10 weeks out. Back to running and all activities including military service and intern year of residency. Not active at all ;-)

5

82

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

When it comes to #Charcot …go big or go home. 300mm FTW. #orthotwitter

8

0

82

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

New c arm with drape that doesn’t fall into the sterile field! Love it. #orthotwitter

6

4

83

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Preop, postop 2 weeks, postop 5 months showing correction and healing of the #MIS #bunion and #bunionnette . #orthotwitter See…they do heal @InvictaOrtho , @rkh_md

12

3

82

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 months

I’m happy to share that I’m starting a new position as Orthopaedic Surgeon at Brigham and Women's Hospital as of 8/5/2024! I will continue my practice with minimally invasive and arthroscopic procedures, ankle replacement and limb reconstruction to Brigham. @BrighamWomens

5

2

82

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

This is why surgeons always ask for the room temp to be “all the way down and low as it can go please.” Before and after a long case wearing lead. Wears my Gatorade? #orthotwitter

11

3

78

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

8 months

All #MIS subtalar fusion #orthotwitter

7

2

78

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

Bunions and bunions today. Looking great 8 weeks out comfortable and getting back to excercise. #orthotwitter consent ☑️

5

6

72

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

Start and finish…TTC fusion and deformity correction FTW! #orthotwitter

7

0

75

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

10 months

It’s burr time. #mis #charcot #orthotwitter @TheFootAnkleDoc @FootAndAnkleMD @chicagofootMD @AnkleInstitute

5

8

73

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

When I showed this to a mentor of mine he had never thought about the loss of 1st ray varus as a sign of injury. Hopefully this case will help others identify this finding in subtle Lisfranc injuries. 12/12

11

4

71

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

How it started How its going #OrthoTwitter #AnkleReplacement

5

9

69

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

One year out and walking comfortably. Very pleased. Total ankle arthroplasty can be an excellent treatment option for the right candidate. #orthotwitter

1

7

70

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

8 months

Before and after ankle scope/anterior cheilectomy. #orthotwitter

4

1

68

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

A fun 3D rendering of a complex fx #orthotwitter

6

9

68

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

6 weeks post-op. #orthotwtitter

5

1

70

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Anyone else dictate stuff this like into your op notes? Has saved me more than once. #orthotwitter

9

4

67

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

What’s happening #orthotwitter ? No fracture?

37

9

67

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

How I hold the 2nd toe correction postop. #orthotwitter #MIS #hammertoe

12

5

65

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

7 months

All MIS Charcot TTC fusion #orthotwitter

5

8

66

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

@Davembmd is this an acceptable preop plan? #orthotwitter Total ankles! @strykerfa

5

7

66

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

The Infinity Adaptis talus with InBone tibia. Really nice immediate fixation with the pegs and 3D printed coating for ingrowth. @strykerfa #anklereplacement #orthotwiter

2

10

63

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

7 months

Just a simple bunion? need to address the metatarsus adductus. Here the MAA is ~35 so it has to be corrected. proximal osteotomies correct the MA alignment prior to the #MIS #bunion correction. #orthotwitter @pmangoneMD @DrAdamBitterman @Ortho_BIDMC @GearinMD @enovismedtech

11

6

64

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

11 months

TTC Fusion Tip: This was an open case, but highlights a common issue I see. The calcaneus is slightly lateral and sometimes when doing the fusion you need to medialize the heel more than you can achieve. A mistake is to force the ankle into varus to accommodate. 1/x #orthotwitter

5

6

62

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

7 months

2 weeks and 3 months following MIS bunion surgery. You can see the bone filling in and healing nicely on the 2nd picture. #orthotwitter

9

6

64

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Very satisfying wire placement #OrthoTwitter

8

7

62

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

“I can’t promise I can make you better, but I can promise that i can make you worse if things go wrong.” Saying “No” is a tough, but crucial part of our profession. @OrthoFolks #orthotwitter #medtwitter

3

6

62

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

Talus fx case. Hawkins 2 neck fracture with subtalar dislocation. Mid 20s F. Two days out from an ankle sprain the ankle still hurt. 1/x

7

9

61

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

3 for 3 of my patients today (TAR, midfoot fusion, Charcot TTC) successfully quit smoking in order to more safely have their surgery. 2 were tearful saying they had wanted to quit for years but never could. #orthotwitter we have significant power to improve lives beyond surgery.

4

2

61

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 months

What is your favorite bone? #orthotwitter

57

1

63

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

What’s your surgical approach to this patient with insertional Achilles pain? #orthotwitter ⁦ @TheFootAnkleDoc ⁩ ⁦ @orthovulcano ⁩ ⁦ @FootAndAnkleMD ⁩ ⁦ @chicagofootMD ⁩

21

7

62

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

@generalorthomd @OrthoYour I actually was not able to imagine what a backward hip replacement even meant when I saw you’re earlier post…but that this is 100% backwards and I will never unsee that.

2

1

61

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Hallux varus #MIS repair…it’s not just about #bunions ! Now walking comfortably for first time in years and able to fit into shoes. #orthotwitter MIS 1st MTP fusion and DMMOs 2-4

4

13

61

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

7 months

Fun times with total ankle replacements. #orthotwitter

5

4

61

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Challenging case. 60 woman with diabetes, neuropathy and inflammatory arthritis. Atraumatic fractures and progressive deformity over course of two years. Severe pain and significant difficulty walking and with any shoe wear. #orthotwitter 1/x

6

61

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

A short 🧵 on judging fibula length and syndesmotic reduction intraop. This was a fibula nonunion with medial instability. Many ways to do it. This is one measure that can help. #OrthoTwitter 1/5

5

12

59

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Let’s talk about subtalar fusions! 55 M with posterior talus fracture malunion. Now with post trauma OA and loss of talar declination. Failed appropriate nonop treatment prior to seeing me. Wants something done to help with walking. #orthotwitter 1/x

10

5

59

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Before and after reduction maneuver. 8/8

4

7

60

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

The resident came prepared for his rotation! #orthotwitter

7

2

59

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Hey #orthotwitter Interns and second year residents…what should you do when you see this xray? What else should you look for? How do you manage it as a consult? Seniors…what next? Approach? Fixation? @InvictaOrtho @DrAdamBitterman @AGianakosDO @harvardortho @FractureDoc

18

9

60

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Reasons why you should save preop photos! One shot tells the whole story. Join the #MIS #bunion team! #OrthoTwitter

7

4

59

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

1 year

Ankle fractures in patients with diabetic neuropathy…sometimes more is more… #orthotwitter

8

6

59

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

5 months

@rkh_md This is awesome. It gets rid of the boring fluffy center part and all the remaining pieces have some crust in it. 10/10 would recommend. What we really need is a baking pan without this part at all

8

1

57

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

4 years

60 year old male with DM and RA. Neuropathy. Lacks protective sensation. Good pulses and cap refill. Worsening pain and deformity. This one took a while! #orthotwitter

7

6

57

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Remember this: For every person that comes to you who is mad about another doctors care there is at least one of your patients going elsewhere upset with you. 7/

7

6

56

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Technical trick for MIS bunions: Use a 3mm steinmann pin in the canal through the osteotomy incision. Shift the head laterally and then strap the toe to the pin with coban. Now you are hands free for the fixation step. #orthotwitter

2

3

57

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

A bad day…infected ankle replacement… #orthotwitter

12

2

55

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

This was the case in my first year of practice when I knew for sure I made the right choice. Combo calc fx, talus fx, lisfranc injury. All open. 5 years later doing well! As a resident I would have run. As an attending I loved every minute. What was your case #orthotwitter ?

6

2

54

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

“Beware the straight medial column.” If you lose the 1st MT varus that is a sign to look for lisfranc. Draw a line parallel to the medial cuneiform and see how it intersects the metatarsal. On injured right side you see it at medial sesamoid. Lateral sesamoid on left. 6/x

3

5

55

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

It’s my favorite tool! And thanks to #orthotwitter I now know that it is called a Joker! Thanks guys! Here we are doing another perc calc orif. The joker let’s you “lock pick” the posterior facet back into place

3

9

52

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

Looking for the ATFL on MRI? Find the slice on axial where the fibula looks like a kidney bean. Here you can see the damaged ATFL (red arrow) which appears wavy. #OrthoTwitter

5

12

52

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

@maggiefrancis @AlextheDPT @schulte_ss I think one factor is that, in general, new moms tend to be younger and healthier in average than patients getting hip and knee replacements and so their limitations/disabilities are ignored/overlooked. “Oh you’ll be ok” ≠ actually being ok

5

0

53

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

5 years

How do people like to treat these? Young active patient. @FootAndAnkleMD @DrAdamBitterman @InvictaOrtho @pmangoneMD

27

12

53

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

5 months

Scoping out a big posterior ankle os trigonum. Patient had severe pain with plantar flexion. #orthotwitter

8

3

52

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

You know you work in health care when you’re breakfast is a protein shake with two shots of espresso mixed in so you only need to carry one things with you on the ride into work. #orthotwitter #efficiency Also this:

1

8

51

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

3 years

~5 weeks out from ankle scope/deltoid repair and @arthrex fibula IMN for a SER 4 equivalent fracture. Healing nicely. Patient is a doctor and is starting intern year next week. WBAT since POD 1. This ankle is ready to crush the ICU! #orthotwitter

3

6

52

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Subtalar bone block arthrodesis for subtalar malunion and post traumatic arthritis. #orthotwitter note the improved talar declination.

4

6

51

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

TTC fusion tip: First wire looked good on AP, but was angled too posterior. However it was holding the alignment nicely. Leave it and bend it out of the way and put a new one in just anterior. You don’t need to re-site the original wire if it’s helping you. #orthotwitter

5

0

49

Christopher Miller, MD, MHS, FAAOS

@BostonFootAnkle

2 years

Chronic Achilles ruptures can be challenging. This patient had an Achilles rupture that was not treated due to her diabetes. I ultimately elected to proceed with with an endoscopic FHL transfer. #orthotwitter @Ortho_BIDMC

5

3

49