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Foot amputation

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https://www.readbyqxmd.com/read/28644115/evaluation-of-the-effectiveness-and-cost-effectiveness-of-lightweight-fibreglass-heel-casts-in-the-management-of-ulcers-of-the-heel-in-diabetes-a-randomised-controlled-trial
#1
William Jeffcoate, Frances Game, Vivienne Turtle-Savage, Alison Musgrove, Patricia Price, Wei Tan, Lucy Bradshaw, Alan Montgomery, Deborah Fitzsimmons, Angela Farr, Thomas Winfield, Ceri Phillips
BACKGROUND: Ulcers of the foot in people with diabetes mellitus are slow to heal and result in considerable cost and patient suffering. The prognosis is worst for ulcers of the heel. OBJECTIVE: To assess both the clinical effectiveness and the cost-effectiveness of lightweight fibreglass casts in the management of heel ulcers. DESIGN: A pragmatic, multicentre, parallel, observer-blinded randomised controlled trial. A central randomisation centre used a computer-generated random number sequence to allocate participants to groups...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28638815/diabetic-foot-workshop-improving-technical-and-educational-skills-for-nurses
#2
Maryam Aalaa, Mahnaz Sanjari, Samimeh Shahbazi, Zahra Shayeganmehr, Maryam Abooeirad, Mohammad Reza Amini, Hossien Adibi, Neda Mehrdad
Diabetes mellitus as one of the most common metabolic disorders has some complications, one of the main ones is diabetic foot (DF). Appropriate care and education prevents 85% of diabetic foot amputations. An ideal management to prevent and treat diabetic foot necessitates a close collaboration between the health team members and the diabetic patient. Therefore, improving nurses' knowledge about DF care and advancement in the quality of care provided by the nurses could significantly improve diabetic foot prevention and management...
2017: Medical Journal of the Islamic Republic of Iran
https://www.readbyqxmd.com/read/28634924/chondroblastoma-in-adult-age
#3
Andrea Angelini, Mohammad Hassani, Andreas F Mavrogenis, Giulia Trovarelli, Carlo Romagnoli, Antonio Berizzi, Pietro Ruggieri
PURPOSE: Chondroblastoma (CB) is a rare benign tumor that occurs most commonly in the second decade of life. No studies on CB in adulthood have been reported. Our purposes were to report a single-institution experience on CB in adults and to discuss the clinical and imaging findings, type of treatment, oncologic and functional outcomes. PATIENTS AND METHODS: All patients diagnosed and treated for CB from 1981 to 2014 were reviewed. The main inclusion criterion was patients above their 30 years of age at diagnosis...
June 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28633785/the-lisfranc-amputation-a-more-reliable-level-of-amputation-with-proper-intraoperative-tendon-balancing
#4
Christopher J Greene, Christopher Bibbo
Traditional transmetatarsal amputations are a reliable level of amputation. However, amputations at the Lisfranc level have met with limited success owing to improper biomechanics resulting from tendon imbalance, ultimately leading to foot deformity positions and an unstable soft tissue envelope with ensuing skin breakdown, infection, and below-the-knee amputation. We describe proper tendon rebalancing that results in improved biomechanics and a more reliable and stable amputation at the more proximal Lisfranc level...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28630763/malignant-tumours-of-the-foot-and-ankle
#5
E Mascard, N Gaspar, L Brugières, C Glorion, S Pannier, A Gomez-Brouchet
Most of tumours of the foot are tumour-like (synovial cyst, foreign body reactions and epidermal inclusion cyst) or benign conditions (tenosynovial giant cells tumours, planta fibromatosis). Malignant tumours of the soft-tissue and skeleton are very rare in the foot and their diagnosis is often delayed with referral to specialised teams after initial inappropriate procedures or unplanned excisions. The adverse effect of these misdiagnosed tumours is the increasing rate of amputation or local recurrences in the involved patients...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28627224/real-time-smart-textile-based-system-to-monitor-pressure-offloading-of-diabetic-foot-ulcers
#6
Andrea Raviglione, Roberto Reif, Maurizio Macagno, Davide Vigano, Justin Schram, David Armstrong
BACKGROUND: The lifetime risk of developing a diabetic foot ulcer (DFU) is at least 25%. A DFU carries a 50% risk for infection and at least 20% of those receive some form of amputation. The most significant parameter that prevents or delays ulcer healing is high plantar pressure. To improve the patient's healing process, the DFU's plantar pressure should remain cumulatively low. Therefore, a tool that continuously measures the DFU loading, and provides real-time feedback can improve the healing outcome...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28623060/amniotic-band-syndrome-with-pseudoarthrosis-of-tibia-and-fibula-a-case-report
#7
Anitha Ananthan, Gayatri Athalye Jape, Jean Du Plessis, Peter Annear, Rohan Page, Shripada Rao
Constriction of the lower limb by a congenital amniotic band has been proposed to explain the development of pseudoarthrosis of the tibia and fibula. We report a case of amniotic band syndrome in a preterm female infant with pseudoarthrosis of the tibia and fibula. She was born at 29 weeks of gestation with congenital amniotic bands and was noted to have a severely edematous left foot distal to the constricting band with rudimentary digits. The skin was pink and well perfused with palpable pulses. Radiography demonstrated pseudoarthrosis of the tibia and fibula...
June 13, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28618729/risk-factors-associated-with-poor-outcome-in-diabetic-foot-ulcer-patients
#8
Saira Saleem, Nazim Hayat, Irshad Ahmed, Tanvir Ahmed, Abdul Gaffar Rehan
BACKGROUND/AIM: Diabetic foot ulcers and related complications are a major cause of morbidity and hospital admissions. Our aim was to evaluate the risk factors associated with poor outcome in diabetic foot ulcers. MATERIALS AND METHODS: A prospective study was conducted on patients with diabetic foot ulceration attending the Madinah Teaching Hospital from June 2014 to December 2015. Potential risk factors and laboratory test results at presentation were recorded and their association with outcome (healing vs...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617050/complications-following-operatively-treated-ankle-fractures-in-insulin-and-non-insulin-dependent-diabetic-patients
#9
Kevin P Haddix, R Carter Clement, Joshua N Tennant, Robert F Ostrum
BACKGROUND: Diabetics with ankle fractures experience more complications than the general population, but it is unclear whether complications differ between type 1 and 2 diabetics and between insulin- and non-insulin-dependent diabetics. This study aims to determine if there is a difference in postoperative complication rates between these groups. METHODS: An administrative health care database from a large commercial insurer was queried to identify operatively treated ankle fractures in patients with type 1 (T1D), type 2 (T2D), type 2 insulin-dependent (T2ID), and type 2 non-insulin-dependent (T2NID) diabetes...
June 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28616080/pedobarography-as-a-clinical-tool-in-the-management-of-diabetic-feet-in-new-zealand-a-feasibility-study
#10
Jason K Gurney, Uwe G Kersting, Dieter Rosenbaum, Ajith Dissanayake, Steve York, Roger Grech, Anthony Ng, Bobbie Milne, James Stanley, Diana Sarfati
BACKGROUND: The peripheral complications of diabetes mellitus remain a significant risk to lower-limb morbidity. In New Zealand, risk of diabetes, comorbidity and lower-limb amputation are highly-differential between demographic groups, particularly ethnicity. There is growing and convincing evidence that the use of pedobarography - or plantar pressure measurement - can usefully inform diabetic foot care, particularly with respect to the prevention of re-ulceration among high-risk patients...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28613416/topical-antimicrobial-agents-for-treating-foot-ulcers-in-people-with-diabetes
#11
REVIEW
Jo C Dumville, Benjamin A Lipsky, Christopher Hoey, Mario Cruciani, Marta Fiscon, Jun Xia
BACKGROUND: People with diabetes are at high risk for developing foot ulcers, which often become infected. These wounds, especially when infected, cause substantial morbidity. Wound treatments should aim to alleviate symptoms, promote healing, and avoid adverse outcomes, especially lower extremity amputation. Topical antimicrobial therapy has been used on diabetic foot ulcers, either as a treatment for clinically infected wounds, or to prevent infection in clinically uninfected wounds...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28606622/reconstruction-of-combined-thumb-amputation-at-the-metacarpal-base-level-and-index-amputation-at-the-metacarpal-level-with-pollicization-and-bilateral-double-toe-composite-transfer
#12
Zhenglin Chi, Da Jiang Song, Lin Tian, Fu Hua Hu, Xiao Fang Shen, Harvey Chim
BACKGROUND: This study aimed to describe the technique and report our experience with the reconstruction of combined proximal thumb amputations at the metacarpal base level and index finger amputation at the metacarpal level with pollicization and bilateral double toe composite transfer. METHODS: The technique consists of pollicization of the remnant index ray. Then a contralateral composite medial great toe pulp and vascularized second toe proximal interphalangeal joint flap are harvested to reconstruct the metacarpophalangeal joint of the thumb...
May 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28606045/patient-impressions-of-possible-catastrophic-outcomes-after-diabetic-foot-ulceration
#13
Benjamin Vickers, Javier La Fontaine, Naohiro Shibuya, Daniel C Jupiter, Zachary Ashmore
BACKGROUND: Diabetes mellitus (DM) and its complications are well studied; patients with diabetes may suffer from neuropathy and vascular issues, and associated with these, lower extremity ulceration. Ulcers are often refractory to treatment, and can be difficult for both patients and clinicians to manage. Such complications may lead to amputations, which in turn are a risk factor for death. However, in certain situations amputation may be the only option available, and may be used as reconstructive surgery, restoring function...
June 12, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28602059/depth-and-combined-infection-is-important-predictor-of-lower-extremity-amputations-in-hospitalized-diabetic-foot-ulcer-patients
#14
Eun-Gyo Jeong, Sung Shim Cho, Sang-Hoon Lee, Kang-Min Lee, Seo-Kyung Woo, Yoongoo Kang, Jae-Seung Yun, Seon-Ah Cha, Yoon-Jung Kim, Yu-Bae Ahn, Seung-Hyun Ko, Jung-Min Lee
Background/Aims: As the prevalence of diabetes mellitus and its complications increase rapidly, diabetic foot ulcers (DFUs), which are a major diabetic complication, are expected to increase. For prevention and effective treatment, it is important to understand the clinical course of DFUs. The aim of this study was to investigate the natural course and predictors of amputation in patients with DFUs who required hospitalization. Methods: A total of 209 patients with type 2 diabetes, aged 30 to 85 years, who visited emergency department or needed hospitalization due to DFUs were consecutively enrolled from May 2012 to January 2016, by retrospective medical record review...
June 7, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28598756/the-impact-of-the-multidisciplinary-team-in-the-management-of-individuals-with-diabetic-foot-ulcers-a-systematic-review
#15
A Buggy, Z Moore
OBJECTIVE: To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. METHOD: A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team...
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28598042/peripheral-vascular-disease-in-patients-with-diabetic-foot-ulcers-an-emerging-trend-a-prospective-study-from-north-india
#16
Supriya Bajaj, Amit Mahajan, Sumit Grover, Vijay Mahajan, Pankaj Goyal, Vikram Kumar Gupta
BACKGROUND: Diabetic foot ulcer is one of the chronic complications of diabetes mellitus (DM) with 25% of patients with diabetes developing a foot ulcer during their lifetime leading to amputation. Diabetic foot is classified into 2 main types: neuropathic ulcers (NPU) and neuro-ischemic ulcer (NIU) where in addition to neuropathy peripheral vascular disease (PVD) is also present. AIMS: We aimed to a) assess the prevalence of Peripheral vascular disease (PVD) in patients of type 2 diabetes mellitus (T2DM) presenting with New Diabetic Foot ulcers (DFU)...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28584901/endovascular-treatment-of-diabetic-peripheral-arterial-disease-in-older-and-oldest-old-patients-a-retrospective-study
#17
Cristina Gatti, Sara Cecchini, Paolo Fabbietti, Fabio Romagnoli, Stefano Ricci
BACKGROUND: Peripheral arterial disease (PAD) is frequent among older diabetic patients, but the evidence about endovascular revascularization is very limited. METHOD: We retrospectively analyzed data collected from 120 diabetic patients consecutively admitted to a Diabetic Foot Clinic, including 64 patients aged 65-79 years and 56 patients aged 80 or more. RESULTS: Percutaneous transluminal angioplasty (PTA) was followed by technical success in 82...
June 3, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28583732/effects-of-topical-negative-pressure-therapy-on-tissue-oxygenation-and-wound-healing-in-vascular-foot-wounds
#18
Nathaniel Chiang, Odette A Rodda, Jamie Sleigh, Thodur Vasudevan
OBJECTIVE: Topical negative pressure (TNP) therapy is widely used in the treatment of acute wounds in vascular patients on the basis of proposed multifactorial benefits. However, numerous recent systematic reviews have concluded that there is inadequate evidence to support its benefits at a scientific level. This study evaluated the changes in wound volume, surface area, depth, collagen deposition, and tissue oxygenation when using TNP therapy compared with traditional dressings in patients with acute high-risk foot wounds...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28576197/soft-tissue-coverage-after-revisional-foot-and-ankle-surgery
#19
REVIEW
Geoffrey G Hallock
Unlike the traumatic "mangled" foot and ankle in which amputation could be an acceptable if not preferred option, revisional foot and ankle surgery starts with a viable foot that is then injured by the surgeon hopefully to benefit the patient. Any untoward sequela, such as inadequate wound healing, instead always requires consideration of limb salvage. Unfortunately, this may not be so simple. A proactive approach to solve this problem in a timely fashion is important. The goal must always be to get a healed wound so the final result improves the ability for independent ambulation by the patient...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576196/management-of-osteomyelitis-and-bone-loss-in-the-diabetic-charcot-foot-and-ankle
#20
REVIEW
Daniel J Short, Thomas Zgonis
Bone loss and destruction due to diabetic Charcot neuroarthropathy (CN) and osteomyelitis of the foot and ankle is a challenging clinical condition when lower extremity preservation is considered. Resection and excision of osteomyelitis and associated nonviable soft tissue can lead into large osseous and soft tissue defects that will most likely need the utilization of bone grafting and subsequent arthrodesis for stability and anatomic alignment. In the diabetic population with peripheral neuropathy, osseous instability can lead to subsequent lower extremity deformity, ulceration, infection and/or amputation...
July 2017: Clinics in Podiatric Medicine and Surgery
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