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foot and ankle, diabetes

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https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#1
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28041815/non-invasive-lower-limb-small-arterial-measures-co-segregate-strongly-with-foot-complications-in-people-with-diabetes
#2
Sean Michael Lanting, Stephen M Twigg, Nathan Anthony Johnson, Michael Kevin Baker, Ian Douglas Caterson, Vivienne Helaine Chuter
AIMS: It is unclear how well non-invasive lower-limb vascular assessments can identify those at risk of foot complications in people with diabetes. We aimed to investigate the relationship between a history of foot complication (ulceration or amputation) and non-invasive vascular assessments in people with diabetes. METHODS: Bilateral ankle-brachial index (ABI), toe brachial index (TBI) and continuous wave Doppler (CWD) were performed in 127 adults with diabetes (97% type 2; age 66...
November 15, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28033047/top-100-cited-foot-and-ankle-related-articles
#3
Patrick A DeHeer, William Adams, Faye-Rose Grebenyuk, Eric Meshulam, Kory Miskin, Tiffany Truong Koch, Corey Groh
BACKGROUND: Article citations are a well-accepted method of evaluating the influence or impact of a particular article. Other medical specialties have published the top cited articles in their specialty. To date, an analysis of the foot and ankle podiatric medicine-related article citation method has not been published. METHODS: Three citation indices were used on October 10, 2014, February 20, 2015, and May 1, 2015, to determine the top 100 cited foot and ankle-related articles...
November 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28031030/outcome-after-protected-full-weightbearing-treatment-in-an-orthopedic-device-in-diabetic-neuropathic-arthropathy-charcot-arthropathy-a-comparison-of-unilaterally-and-bilaterally-affected-patients
#4
Niklas Renner, Stephan Hermann Wirth, Georg Osterhoff, Thomas Böni, Martin Berli
BACKGROUND: Charcot neuropathic arthropathy (CN) is a chronic, progressive, destructive, non-infectious process that most frequently affects the bone architecture of the foot in patients with sensory neuropathy. We evaluated the outcome of protected weightbearing treatment of CN in unilaterally and bilaterally affected patients and secondarily compared outcomes in protected versus unprotected weightbearing treatment. METHODS: Patient records and radiographs from 2002 to 2012 were retrospectively analyzed...
December 29, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28009675/effects-of-foot-and-ankle-devices-on-balance-gait-and-falls-in-adults-with-sensory-perception-loss-a-systematic-review
#5
Joanne Paton, Anna L Hatton, Keith Rome, Bridie Kent
BACKGROUND: Foot and ankle devices are being developed as a method of preventing people with sensory perception loss sustaining a fall. Such devices are believed to work by reducing the likelihood of a fall by improving the balance and gait of the user. OBJECTIVES: The objective of the review was to evaluate the effectiveness of foot and ankle devices for the prevention of falls and the improvement of balance and gait in adults with sensory perception loss. INCLUSION CRITERIA TYPES OF PARTICIPANTS: Participants were community-dwelling adults with bilateral pathological sensory perception loss...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27926682/clinical-outcomes-of-nonunions-of-hindfoot-and-ankle-fusions
#6
Fabian Krause, Alastair S E Younger, Judith F Baumhauer, Timothy R Daniels, Mark Glazebrook, Peter T Evangelista, Michael S Pinzur, Gowreeson Thevendran, Rafe M J Donahue, Christopher W DiGiovanni
BACKGROUND: While nonunion after foot and ankle fusion surgery has been associated with poor outcomes, we are not aware of any longitudinal study on this subject. Thus, we prospectively evaluated the impact of nonunion on clinical outcomes of foot and ankle fusions and identified potential risk factors for nonunion after these procedures. METHODS: Using data from a randomized clinical trial on recombinant human platelet-derived growth factor-BB (rhPDGF-BB; Augment Bone Graft, BioMimetic Therapeutics), union was defined either by assessment of computed tomography (CT) scans at 24 weeks by a reviewer blinded to the type of treatment or by the surgeon's composite assessment of clinical and radiographic findings at 52 weeks and CT findings at 24 or 36 weeks...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27923216/efficacy-of-a-cellular-bone-allograft-for-foot-and-ankle-arthrodesis-and-revision-nonunion-procedures
#7
Travis J Dekker, Peter White, Samuel B Adams
BACKGROUND: Bone graft substitutes are often required in patients at risk for nonunion, and therefore, an allograft that most closely mimics an autograft is highly sought after. This study explored the utility and efficacy of a cellular bone allograft used for foot and ankle arthrodesis and revision nonunion procedures in a patient population at risk for nonunion. METHODS: An institutional review board-approved retrospective review of consecutive patients who underwent arthrodesis and revision nonunion procedures with a cellular bone allograft was performed at a single academic institution...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27921418/-diabetic-foot-syndrome-from-the-perspective-of-internist-educated-in-podiatry
#8
Alexandra Jirkovská
Podiatry is the science dealing with the diagnostics and treatment of the foot and ankle and associated tissues and structures by all appropriate methods and also with the local manifestation of the overall processes in this area. Diabetic foot disease is defined as infection, ulceration or destruction of tissues of the foot associated with neuropathy and/or peripheral artery disease in the lower extremity of people with diabetes according to the latest edition of the International Consensus. Successful treatment and prevention of diabetic foot syndrome depends on a holistic approach, in which it is seen as part of the multiple organ involvement...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27898266/methicillin-resistant-staphylococcus-aureus-in-foot-osteomyelitis
#9
Chester N Ashong, Shazia A Raheem, Andrew S Hunter, Cezarina Mindru, Neal R Barshes
BACKGROUND: Conflicting studies exist regarding the impact of methicillin-resistant Staphylococcus aureus (MRSA) on increased time to wound healing, future need for surgical procedures, and likelihood of treatment failure in patients with diabetic foot osteomyelitis. The purpose of this study is to determine the overall significance of MRSA in predicting treatment failure in bone infections of the foot and to determine an appropriate pre-operative and empiric post-operative antibiotic regimen...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27888847/mr-imaging-of-the-diabetic-foot
#10
REVIEW
Eoghan McCarthy, William B Morrison, Adam C Zoga
Abnormalities of the peripheral nervous, vascular, and immune systems contribute to the development of numerous foot and ankle pathologies in the diabetic population. Although radiographs remain the most practical first-line imaging tool, magnetic resonance (MR) is the tertiary imaging modality of choice, allowing for optimal assessment of bone and soft tissue abnormalities. MR allows for the accurate distinction between osteomyelitis/septic arthritis and neuropathic osteoarthropathy. Furthermore, it provides an excellent presurgical anatomic road map of involved tissues and devitalized skin to ensure successful limited amputations when required...
February 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/27882360/static-and-dynamic-predictors-of-foot-progression-angle-in-individuals-with-and-without-diabetes-mellitus-and-peripheral-neuropathy
#11
Ericka N Merriwether, Mary K Hastings, Michael J Mueller, Kathryn L Bohnert, Michael J Strube, Darrah R Snozek, David R Sinacore
INTRODUCTION: Foot progression angle (FPA) is a predictor of elevated regional plantar stresses and loads, which are indicators of dermal injury risk in individuals with diabetes mellitus and peripheral neuropathy (DMPN). FPA accounts for 15-45% of the variance in plantar stresses and loads in adults with DMPN. However, the biomechanical factors underlying an "out-toeing" gait pattern in this clinical population have not been examined. The primary purpose of this study was to identify static and dynamic predictors of foot progression angle magnitude in adults with and without DMPN...
2016: Annals of Gerontology and Geriatric Research
https://www.readbyqxmd.com/read/27871418/efficacy-of-a-cellular-allogeneic-bone-graft-in-foot-and-ankle-arthrodesis-procedures
#12
REVIEW
Travis J Dekker, Peter White, Samuel B Adams
A cellular allogeneic bone graft can be used in patients at high risk for nonunion after arthrodesis surgery. This study explores the utility and efficacy of MAP3 in foot and ankle arthrodesis procedures. Map3 is a cellular allogeneic bone graft that contains osteogenic, osteoconductive, osteoinductive, and angiogenic properties. A total of 23 mostly high-risk patients were included in this study. The overall fusion rate was 83%. Univariate analysis demonstrated diabetic patients remain at risk of recurrent nonunion (P<...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27865320/the-diabetic-charcot-foot-and-ankle-a-multidisciplinary-team-approach
#13
EDITORIAL
Thomas Zgonis
No abstract text is available yet for this article.
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#14
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865317/revisional-surgery-of-the-diabetic-charcot-foot-and-ankle
#15
REVIEW
Patrick R Burns, Spencer J Monaco
Charcot neuroarthropathy (CN) is a difficult problem for the foot and ankle surgeon. If surgery is required, little is known or available regarding the best methods and timing. When the initial attempt of reconstruction fails, revision of CN is even more demanding. One must take in to account all aspects, including nutrition, vascular status, infection control, short- and long-term blood glucose management, as well as other factors requiring laboratory monitoring and consult services. Once optimized, the biomechanics of the deformity can be addressed and decisions can be made on fixation devices...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#16
REVIEW
Claire M Capobianco, Thomas Zgonis
Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#17
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865313/surgical-equinus-correction-for-the-diabetic-charcot-foot-what-the-evidence-reveals
#18
REVIEW
Claire M Capobianco
Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865312/an-overview-of-internal-and-external-fixation-methods-for-the-diabetic-charcot-foot-and-ankle
#19
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865310/the-diabetic-charcot-foot-from-1936-to-2016-eighty-years-later-and-still-growing
#20
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Knowledge of diabetic Charcot neuroarthropathy (DCN) has grown tremendously since this condition was first described in 1936 by William Riely Jordan. Despite advancements in diagnostic approaches and treatment options making DCN limb salvage a more viable option, ongoing and additional research is needed to determine the definitive pathogenesis, which may aid in prevention of the condition. This article chronicles the main developments for the study and management of DCN since 1936 and recommends using the term diabetic Charcot-Jordan foot when specifically managing foot and ankle neuroarthropathy joints in patients with diabetic neuropathy...
January 2017: Clinics in Podiatric Medicine and Surgery
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