Abstract:
:These two morbidly obese patients with severe Charcot foot arthropathy were treated successfully with percutaneous correction of their deformity followed by a stepwise application of a pre-assembled neutrally aligned multiplane ring external fixator. This technique transfers well to the trauma environment in which alignment can be maintained without further violation within the zone of injury. The application of the fine wire ring external fixation has been used for many years to accomplished leg lengthening and correction of deformity. Historically it has required a great deal of experience to apply to complex frames and implement the required daily adjustments. The patient experience often has been an unpleasant ordeal with a high potential for associated morbidity. This negative exposure has prompted practicing orthopedic surgeons to avoid this technique, feeling that it best be left to those in tertiary care setting who are equipped to handle the morbidity and complications. Taking this technology from the domain of the deformity surgeon to the general orthopedic community will require the suppression of bad memories from residency. Using the device solely as a method of maintaining alignment eliminates many of the dynamic attributes that contributes to pain and morbidity. The bone and soft tissues are not stretched, eliminating much of the pain and decreasing the rate of traction-associated pin tract morbidity. Because there is no dynamic of the treatment, the simplified frame can be pre-assembled and have no adjustable components. The experience derived from this application has the potential of expanding the role of ring external fixation. Where the ring has been used previously as method of both obtaining and maintaining alignment, this application uses a simplified neutral version of a complex device to simply maintain alignment in a high risk patient population. Correction of deformity and achieving alignment/reduction of fractures is well within the domain of practicing orthopedic surgeon. Once that correction has been achieved, this application simply maintains that correction. It helps avoid extensive surgical dissection in a poor host and eliminates the need for bone that is mechanically capable of holding internal fixation devices during the bony and soft tissue healing period.
journal_name
Foot Ankle Clinjournal_title
Foot and ankle clinicsauthors
Pinzur MSdoi
10.1016/j.fcl.2006.06.006subject
Has Abstractpub_date
2006-12-01 00:00:00pages
837-47issue
4eissn
1083-7515issn
1558-1934pii
S1083-7515(06)00050-7journal_volume
11pub_type
杂志文章,评审abstract::Brachymetatarsia is a rare clinical entity that presents a complicated case to the treating surgeon. One-stage lengthening procedures with a variety of biologic and synthetic implants are preferred for metatarsals that only need to be lengthened up to 15 mm, whereas gradual lengthening allows for greater length gain a...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2004.05.002
更新日期:2004-09-01 00:00:00
abstract::Walking function may be enhanced by correcting equinus and equinovarus deformities in CP. Nonoperative management should be used in young children. Muscle balancing procedures, such as gastrocnemius aponeurosis lengthening, Achilles' tendon lengthening, and SPLATT, are particularly useful in correcting these deformiti...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract::This article discusses the complications after open reduction and internal fixation of ankle fractures. Complications are classified as perioperative (malreduction, inadequate fixation, and intra-articular penetration of hardware), early postoperative (wound edge dehiscence, necrosis, infection and compartment syndrom...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(02)00162-6
更新日期:2003-03-01 00:00:00
abstract::Many techniques have been described for surgical management of lateral ankle instability. Anatomic repair and nonanatomic reconstruction have higher recurrence rates, and may be complicated by ankle stiffness. Anatomic reconstruction should be considered in stabilization for deficiencies of the lateral ankle ligament ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2006.06.017
更新日期:2006-09-01 00:00:00
abstract::Imaging of the subtalar joint can be challenging because of its complex planar anatomy. This article reviews the anatomy and common anatomic variants as seen with different imaging techniques. Although radiography remains the initial mode of imaging, computed tomography and MRI are frequently needed to better delineat...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2015.02.009
更新日期:2015-06-01 00:00:00
abstract::Plantar plate rupture is a common cause of forefoot pain, multiplanar malalignment, subluxation, or dislocation of the metatarsophalangeal joint (MTPJ). The treatments that have been described for MTPJ instability of lesser toes include amputation, lengthening and/or tendon transfer, periarticular soft-tissue release ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章
doi:10.1016/j.fcl.2012.06.004
更新日期:2012-09-01 00:00:00
abstract::Metatarsus adductus (MA) is a congenital condition resulting in adduction of the forefoot at the tarsometatarsal joint, medial metatarsal deviation, supination of the hindfoot through the subtalar joint, and plantarflexed first ray. The exact underlying pathophysiology remains elusive. There is increasing evidence hig...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2019.08.002
更新日期:2019-12-01 00:00:00
abstract::There are many psychologic effects to trauma and disease. Patients often exhibit a grief reaction and loss of identity in the early stages of recovery. Fear and anxiety about the physical condition and future independence can contribute to feelings of separation and loneliness in patients. Loss of self-confidence and ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(03)00100-1
更新日期:2001-06-01 00:00:00
abstract::Lateral talar process fractures (LTPF) are uncommon injuries but have become more relevant with snowboarding. Currently the fractures are classified according to McCrory-Bladin into 3 types, with advice for treatment that is not ideal anymore. This article proposes modifying the existing classification by differentiat...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2018.04.009
更新日期:2018-09-01 00:00:00
abstract::Tarsometatarsal (TMT) joint complex injuries can be caused by either direct or indirect injuries. The Lisfranc joint represents approximately 0.2% of all fractures. Up to 20% of these injuries are misdiagnosed or missed on initial radiographic assessment; therefore, a high index of suspicion is needed to accurately di...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2018.07.014
更新日期:2018-12-01 00:00:00
abstract::Peroneal tendoscopy is indicated for peroneal tenosynovitis, subluxation or dislocation, snapping, partial tears requiring debridement, and postoperative adhesions and scarring. Peroneal tendoscopy was also found to be valuable as a diagnostic tool in some instances. It is generally reported to have good to excellent ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2014.10.011
更新日期:2015-03-01 00:00:00
abstract::This article reviews the indications and the operative technique for the medial calcaneal slide osteotomy for the treatment of posterior tibial insufficiency. Patient selection, expected results, and complications of this technique are discussed. When used in combination with flexor digitorum longus transfer, the medi...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(03)00081-0
更新日期:2001-03-01 00:00:00
abstract::For years, OCD of the talus has been known as a symptomatic lesion that causes pain, recurrent synovitis, altered joint mechanism, and obstruction from loose bodies. It is a probable precursor of ankle osteoarthritis because of altered joint mechanics and recurrent synovitis. With the notable advance of diagnostic ima...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(03)00017-2
更新日期:2003-06-01 00:00:00
abstract::Severe ankle degeneration can be a devastating problem for young adults. Although ankle fusion continues to be the gold standard, inherent long-term problems are related to this treatment option. Further advances in total ankle prosthetic arthroplasty are needed before this treatment option can be considered suitable ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2006.12.001
更新日期:2007-03-01 00:00:00
abstract::Joint replacement of the hallux metatarsophalangeal joint has not enjoyed the same success as hip and knee arthroplasties. Silastic implants have achieved a high patient satisfactory rate but have caused many complications, including silicone synovitis and lymph node inflammation. Metal and polyethylene hemiarthroplas...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2004.09.002
更新日期:2005-03-01 00:00:00
abstract::Surgical decompression of peripheral nerves for the treatment of diabetic peripheral neuropathy has been studied and previously reported. These studies reported decreased pain and some studies showed improved sensory function. The role that this surgery can play remains controversial. ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2003.12.001
更新日期:2004-06-01 00:00:00
abstract::In athletes, foot injuries present with a variety of mechanisms, severity, and implications for return to play. Although potentially given less attention than knee and shoulder injuries by the team physician, foot injuries are common and thus require knowledgeable consideration. In this article, we review the anatomy,...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2020.12.001
更新日期:2021-03-01 00:00:00
abstract::As our understanding of the underlying cause of flat foot progression improves so will our understanding of how best to catalog and treat the instabilities that are seen. Determining the failure of one type of treatment will be difficult until we can better define the varied pathology and give the treatment methods su...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(03)00063-9
更新日期:2003-09-01 00:00:00
abstract::Avascular necrosis of the foot and ankle is a rare but important cause of pain and functional abnormality. This process may occur in any bone in the foot and ankle; however, it presents most often in characteristic locations. Understanding of key radiographic findings is important in management of these lesions. MRI i...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2018.10.002
更新日期:2019-03-01 00:00:00
abstract::This article reviews the role of cavus in foot and ankle injury and summarizes the current surgical and nonsurgical treatments. Recognition of foot position is crucial in the management of ankle instability associated with cavovarus. Correcting foot alignment with orthoses or surgery improves the mechanics of the ankl...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2013.08.005
更新日期:2013-12-01 00:00:00
abstract::The incidence of AT rupture has increased in recent decades. AT ruptures frequently occur in the third or fourth decade of life in sedentary individuals who play sport occasionally. Ruptures also occur in elite athletes. Clinical examination must be followed by imaging. Conservative management and early mobilization c...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2013.02.009
更新日期:2013-06-01 00:00:00
abstract::Using radiographs culled over a 33-month period, the treatment, complications, revision, and rehabilitation of complicated Jones fractures and stress fractures involving the proximal diaphysis are examined. Although the non-operative approach remains viable, the exigencies and desires of the athletic and leg-based wor...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2009.04.001
更新日期:2009-06-01 00:00:00
abstract::External fixators have been used effectively for a variety of traumatic, congenital, and neuromuscular conditions of the lower extremity for many decades. The transition to management of Charcot foot and ankle deformities in the diabetic neuropathic patient is a logical application. External fixation can address the u...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(02)00019-0
更新日期:2002-03-01 00:00:00
abstract::Distal tibial osteotomy is an effective treatment for a variety of pediatric and adult foot and ankle disorders. Exposure osteotomies provide access to the tibiotalar joint for such problems as talar body fractures and osteochondral lesions of the talus. The channel osteotomy provides improved access to posterior tala...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(03)00115-3
更新日期:2001-09-01 00:00:00
abstract::Hallux valgus is an extremely common and often disabling deformity. In addition to valgus deformity of the hallux, varying degrees of varus and supination of the first metatarsal and instability in the metatarsophalangeal and metatarsocuneiform joints are frequently present. Because of the complexity and multiplicity ...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2019.10.006
更新日期:2020-03-01 00:00:00
abstract::With advanced surgical techniques and orthotic, as well as prosthetic devices, partial foot amputations have become a viable alternative. Orthotics can help restore stability, maintain support, and protect function of the residual limb. The authors discuss orthotic and prosthetic management of patients who have underg...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/s1083-7515(03)00090-1
更新日期:2001-06-01 00:00:00
abstract::Achilles tendinopathy is a painful condition that occurs commonly in both active and inactive individuals. It seems that this condition is painful as a result of ingrowth of neural structures and neovessels leading to poor healing, rather than from inflammatory mediators. Traditional conservative measures are often su...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2009.07.003
更新日期:2009-12-01 00:00:00
abstract::There is a paucity of information on adult coalitions without large, well-designed outcome studies. Current recommendations are thus similar to those for adolescents. Based on the available literature, current recommendations include an initial trial of adequate nonoperative treatment in symptomatic coalitions. Unlike...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2012.03.004
更新日期:2012-06-01 00:00:00
abstract::Ankle sprains are common in both sport and leisure activities. Despite the high success rates of conservative management, approximately 10% to 30% patients develop chronic instability. Surgery yields high success rates, but clinical problems such as functional and mechanical instability, persistent talar tilt, range o...
journal_title:Foot and ankle clinics
pub_type: 杂志文章,评审
doi:10.1016/j.fcl.2006.06.001
更新日期:2006-09-01 00:00:00
abstract::Amputations of the lower extremity may result from several etiologic factors. Most amputations performed in the United States result from a dysvascular limb. A majority of the population with vascular impairment comprises people with diabetes. These individuals frequently have comorbidities that may also affect the ul...
journal_title:Foot and ankle clinics
pub_type: 杂志文章
doi:10.1016/j.fcl.2010.05.001
更新日期:2010-09-01 00:00:00