Abstract:
BACKGROUND:Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of different procedures performed for limb salvage in this population. METHODS:This study retrospectively reviewed 17 patients with DM complicated by peripheral neuropathy who sustained a bimalleolar ankle fracture and failed initial operative management. Patients were treated with revision open reduction internal fixation (ORIF) (3/17), closed reduction external fixation (CREF) (8/17), or primary ankle joint fusion (3/17 tibiotalocalcaneal fusion with hindfoot nail [TTCN] and 3/17 with tibiotalar arthrodesis using plates and screws [TTA]). Median follow-up was 20 months. RESULTS:The overall rate of limb salvage was 82.3% (14/17). All patients who went on to amputation presented with infection and were treated initially with CREF (3/3). All patients who achieved successful limb salvage ended up with a clinically fused ankle joint (14/14); 9 underwent a primary or delayed formal fusion and 5 had a clinically fused ankle joint at study conclusion after undergoing revision ORIF or CREF with adjunctive procedures. CONCLUSION:This small study suggests that in this complicated group of patients it is difficult to achieve limb salvage with an end result of a functional ankle joint. CREF can be a viable option in cases where underlying infection or poor bone quality is present. Treatment with revision ORIF frequently requires supplementary external fixator or tibiotalar Steinman pin placement for additional stability. All patients who underwent revision ORIF ended up with clinically fused ankle joints at the end of the study period. Primary fusion procedures (TTA, TTCN) were associated with a high rate of limb salvage and a decreased number of operations. LEVEL OF EVIDENCE:Level III, retrospective case series.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Vaudreuil NJ,Fourman MS,Wukich DKdoi
10.1177/1071100716676063subject
Has Abstractpub_date
2017-03-01 00:00:00pages
248-254issue
3eissn
1071-1007issn
1944-7876pii
1071100716676063journal_volume
38pub_type
杂志文章abstract:BACKGROUND:The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. METHODS:Data were analyzed f...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100716658975
更新日期:2016-11-01 00:00:00
abstract::Bilateral symmetrical Achilles tendon ossification is presented, with a fracture on one side. A 57 year old male patient was conservatively treated for bilateral clubfeet in his childhood. Part of his Achilles tendons were replaced by ectopic bony mass and on the left it fractured without any trauma. The fracture was ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002101206
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:A proximal spherical metatarsal osteotomy was devised to correct not only varus deviation of the first metatarsal, but also dorsiflexion. We expected to increase the medial longitudinal arch by adding plantar flexion at the osteotomy site. To investigate the limitations of this procedure for feet with severe...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2008.1025
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Although a variety of surgical techniques are available for the treatment of ankle degenerative disease, arthrodesis is a common treatment especially for unilateral posttraumatic arthritis in young patients. A clear trend toward internal fixation for ankle arthrodesis is evident, but fusion site compression ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100713483097
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The incidence and potential life-threatening complications of thromboembolic disease after major orthopaedic surgery has been extensively studied. However, there are two studies pertaining to the incidence of thromboembolic disease after foot and ankle surgery, the findings of which suggest that the incidenc...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070602700907
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Patients with diabetes who sustain an ankle fracture are at increased risk for complications including higher rates of in hospital mortality, in-hospital postoperative complications, length of stay and non-routine discharges. The purpose of this study was to retrospectively compare the complications associat...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2011.0120
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Microsurgical reconstruction has improved limb salvage in patients who because of many etiologies have soft-tissue loss from the lower extremities. Free-tissue transfer to the foot and ankle often interferes with postoperative function and footwear because of the bulk of a muscle flap. The foot and ankle oft...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600302
更新日期:2005-03-01 00:00:00
abstract::Eleven consecutive patients with 12 stress fractures of the foot or ankle were seen between October 1992 and July 1995. Charts were reviewed retrospectively for clinical information. The patients were all postmenopausal females. Average age was 62 years. Onset of symptoms was not associated with a specific episode of ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079801900406
更新日期:1998-04-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
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abstract::In triple arthrodesis performed for severe deformity and neuroarthropathy in poorly compliant patients with osteoporotic bone, fixation of the arthrodesis is critical. We biomechanically tested an alternative means of stabilization for calcaneocuboid fusions. In seven matched pairs of fresh-frozen cadaver feet, we rem...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079902000107
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND::The effect of bone mineral density (BMD) on outcomes from total ankle arthroplasty (TAA) has not been studied. BMD can be estimated by measuring Hounsfield units (HU) on standard computed tomography (CT), which is frequently performed prior to TAA. We aimed to identify whether tibial and talar HU measured f...
journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
abstract::Chronic exertional compartment syndrome (CECS) of the leg is a debilitating condition that has previously been characterized in athletes and military personnel. The results of surgical management in these patient populations have previously been published with inconsistencies in surgical methods and patient outcomes n...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719842798
更新日期:2019-07-01 00:00:00
abstract::Damage to the dorsomedial cutaneous nerve of the foot, which innervates the medial hallux, may occur with crush injury or iatrogenically with bunion surgery. Severe neuritic pain after bunion surgery may alert the surgeon that this small nerve has been damaged. The term "dorsomedial cutaneous nerve syndrome" is sugges...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070102200305
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:One of the major concerns with lateral column lengthening (LCL) in symptomatic flatfoot deformity treatment is the risk of postoperative plantar lateral foot discomfort. We evaluated whether this risk can be minimized by using trial metal wedges. Using our study's evaluation tools, the incidence of postopera...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2011.0665
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Understanding the plantar nerve anatomy is crucial for safe endoscopic surgery of the sole. We aimed to anatomically dissect the lateral aspect and soles of cadaveric feet to investigate the safety of peroneus longus tendoscopy with a plantar lateral portal and the safe zones for plantar portals. METHODS:We...
journal_title:Foot & ankle international
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abstract:BACKGROUND:Liposomal bupivacaine is increasingly being utilized in attempts to provide prolonged local analgesia in the immediate postoperative period. The purpose of this study was to quantify the reduction in opioid consumption as well as postoperative pain scores in the postoperative period when liposomal bupivacain...
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journal_title:Foot & ankle international
pub_type: 临床试验,杂志文章
doi:10.1177/107110079501600305
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:The tendo Achilles (TA) is a tendon very susceptible to injury. Biomechanical methodologies for exploring tendon strain are limited, however, as they are typically performed in vitro or by indirectly measuring the displacement of reference markers. By using panoramic ultrasound, this study reports a novel ap...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2010.0905
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:We performed a laboratory-based study of the ankle-hindfoot complex in normal cadaveric ankles with simulated lateral ankle ligament injuries, utilizing an ankle stability testing device. The ankle stability testing device distinguished between intact, injury to anterior talofibular ligament (ATFL) and combi...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2010.0531
更新日期:2010-06-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2007.0971
更新日期:2007-09-01 00:00:00
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journal_title:Foot & ankle international
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abstract:BACKGROUND:The incidence of Achilles ruptures has been on the rise in National Collegiate Athletic Association (NCAA) football players, but the career impact of this injury is not fully understood. In this study, we analyzed a large series of Achilles tendon injuries in NCAA Football Bowl Subdivision (FBS) defensive fo...
journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:1994-11-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2007.1124
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Little data exist regarding the adverse effects of Achilles tendon (AT) elongation after rupture repair on plantarflexion strength. This study aimed to investigate the effect of AT elongation measured using AT resting angle (ATRA) on the plantarflexion strength in patients with surgically treated acute AT ru...
journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:2020-02-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:2009-04-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002100202
更新日期:2000-02-01 00:00:00