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https://www.readbyqxmd.com/read/28323802/outcomes-after-severe-distal-tibia-ankle-and-or-foot-trauma-comparison-of-limb-salvage-versus-transtibial-amputation-outlet
#1
Michael J Bosse, David Teague, Lisa Reider, Joshua L Gary, Saam Morshed, Rachel B Seymour, James Toledano, Lisa K Cannada, Barbara Steverson, Daniel O Scharfstein, Jason Luly, Ellen J MacKenzie
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28318394/effect-of-foot-and-ankle-immobilization-on-able-bodied-gait-as-a-model-to-increase-understanding-about-bilateral-transtibial-amputee-gait
#2
Antonia Nepomuceno, Matthew J Major, Rebecca Stine, Steven Gard
BACKGROUND: The anatomical foot-ankle complex facilitates advancement of the stance limb through foot rockers and late-stance power generation during walking, but this mechanism is altered for persons with bilateral transtibial amputation when using passive prostheses. OBJECTIVES: To study the effects of bilateral foot and ankle immobilization on able-bodied gait to serve as a model for understanding gait of persons with bilateral transtibial amputation and associated compensatory mechanisms...
March 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#3
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28302263/lower-limb-amputation-in-germany
#4
Knut Kröger, Christian Berg, Frans Santosa, Nasser Malyar, Holger Reinecke
BACKGROUND: Declining amputation rates have been reported in multiple countries in recent years. It is not yet known whether amputation rates have declined in Germany as well. METHODS: On the basis of DRG (diagnosis-related group) data, we received a list from the German Federal Statistical Office of all major and minor amputations documented in German hospitals from 2005 to 2014. Changes over this period were studied with linear regression. RESULTS: The absolute number of amputations per year in Germany rose slightly from 55 689 in 2005 to 57 637 (+3...
February 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28302229/dot-in-circle-sign-a-diagnostic-mri-sign-for-madura-foot
#5
Faiza Javed, Rashid Nazir, Manoj Sharma, Sanam Yasir, Sadia Babar
Mycetoma is a slowly progressive localised, granulomatous, subcutaneous tissue infection common among adult males aged 20 - 50 years. The causing agents include both bacteria (actinomycetoma) and fungi (eumycetoma). This chronic infection was described in literature as Madura foot and eventually mycetoma, due to its etiology. Early clinical diagnosis before the appearance of sinuses and grains (aggregates of organism surrounded by granulation tissue, which are discharged from the draining sinuses) is difficult...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28292565/toe-pressure-and-toe-brachial-index-are-predictive-of-cardiovascular-mortality-overall-mortality-and-amputation-free-survival-in-patients-with-peripheral-artery-disease
#6
J-E Wickström, M Laivuori, E Aro, R T Sund, O Hautero, M Venermo, J Jalkanen, H Hakovirta
OBJECTIVE/BACKGROUND: Peripheral haemodynamic parameters are used to assess the presence and severity of peripheral artery disease (PAD). The prognostic value of ankle brachial index (ABI) has been thoroughly delineated. Nonetheless, the relative usefulness of ankle pressure (AP), ABI, toe pressure (TP), and toe brachial index (TBI) in assessing patient outcome has not been investigated in a concurrent study setting. This study aimed to resolve the association of all four non-invasive haemodynamic parameters in clinically symptomatic patients with PAD with cardiovascular mortality, overall mortality, and amputation free survival (AFS)...
March 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28289465/an-exploration-of-diabetic-foot-screening-procedures-data-by-a-multiple-correspondence-analysis
#7
Vilma Urbančič Rovan, Jože Rovan
AIMS: Gangrene and amputation are among most feared complications of diabetes mellitus. Early detection of patients at high risk for foot ulceration can prevent foot complications. Regular foot screening (medical history, foot examination and classification into risk groups) was introduced at the out-patient diabetes clinic in Ljubljana in November 1996. We aimed to explore the relationships between the observed variables, check the appropriateness of the risk status classification and of the post-screening decisions...
March 1, 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28288686/outcomes-of-dysvascular-partial-foot-amputation-and-how-these-compare-to-transtibial-amputation-a-systematic-review-for-the-development-of-shared-decision-making-resources
#8
Michael P Dillon, Matthew Quigley, Stefania Fatone
BACKGROUND: Dysvascular partial foot amputation (PFA) is a common sequel to advanced peripheral vascular disease. Helping inform difficult discussions between patients and practitioners about the level of PFA, or the decision to have a transtibial amputation (TTA) as an alternative, requires an understanding of the current research evidence on a wide range of topics including wound healing, reamputation, quality of life, mobility, functional ability, participation, pain and psychosocial outcomes, and mortality...
March 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28288437/podiatry-impact-on-high-low-amputation-ratio-characteristics-a-16-year-retrospective-study
#9
Brian M Schmidt, James S Wrobel, Michael Munson, Gary Rothenberg, Crystal M Holmes
PURPOSE: Complications from diabetes mellitus including major lower extremity amputation may have significant impact on a patient's mortality. This study determined what impact the addition of a limb salvage and diabetic foot program involving podiatry had at an academic institution over 16years by analyzing high-low amputation ratio data. METHODS: The high-low amputation ratio in the diabetic population who underwent non-traumatic amputation of the lower extremity was retrospectively evaluated at an academic institution via cohort discovery of the electronic medical record and analysis of billing over 16years...
February 21, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28288436/cell-therapy-of-critical-limb-ischemia-in-diabetic-patients-state-of-art
#10
REVIEW
Michal Dubský, Alexandra Jirkovská, Robert Bem, Andrea Nemcová, Vladimira Fejfarová, Edward B Jude
In this review we report on the state of cell therapy of critical limb ischemia (CLI) with respect to differences between diabetic and non-diabetic patients mainly from the clinical point of view. CLI is the most severe form of peripheral arterial disease and its diagnosis and treatment in diabetic patients is very difficult. The therapeutic effect of standard methods of CLI treatment is only partial - more than one third of diabetic patients are not eligible for standard revascularization; therefore, new therapeutic techniques such as cell therapy have been studied in clinical trials...
February 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28286632/can-ratio-of-neutrophil-to-lymphocyte-count-and-erythrocyte-sedimentation-rate-in-diabetic-foot-infecti-on-predict-osteomyelitis-and-or-amputation
#11
Oktay Yapıcı, Hande Berk, Nefise Öztoprak, Derya Seyman, Alper Tahmaz, Alparslan Merdin
The aim of this study was to search for any relations between the neutrophil-to-lymphocyte ratio (NLR) and the development of osteomyelitis and the need for amputation in patients with diabetic foot infection (DFI). All data included DFI patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease Code System. 75 patients were analyzed in the study. The DFI patients were stratified into 3 groups of whom had amputation procedure, whom had only debridement/drainage procedure and whom had any surgery procedure...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28283002/losing-a-foot-versus-losing-a-dollar-a-systematic-review-of-cost-studies-in-diabetic-foot-complications
#12
Ioannis Petrakis, Ilias J Kyriopoulos, Alexandros Ginis, Kostas Athanasakis
Diabetes mellitus is a chronic disease with high prevalence worldwide and a range of serious related complications. Amongst them, diabetic foot is one of the most disabling, posing a substantial health and economic burden on patients and healthcare systems. Areas Covered: According to projections, the expected lower limb morbidity is about to increase - in this light the present review aimed at identifying cost-of-illness studies on the management and treatment of conditions related to the diabetic foot, in an aim to provide a body of evidence for an increasing health care burden...
March 10, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28279723/physiologic-cryoamputation-in-managing-critically-ill-patients-with-septic-advanced-acute-limb-ischemia
#13
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Roy M Fujitani
OBJECTIVES: Certain critically ill patients with advanced acute limb ischemia with a non-viable extremity may be unsuitable for transport to the operating room to undergo definitive amputation. In these unstable patients, rapid regional cryotherapy allows for prompt infectious source control and correction of hemodynamic and metabolic abnormalities, thereby lessening the risk associated with definitive surgical amputation. We describe our refined technique for lower extremity physiologic cryoamputation and review our institutional experience...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28278172/the-influence-of-a-hydraulic-prosthetic-ankle-on-residual-limb-loading-during-sloped-walking
#14
Sara R Koehler-McNicholas, Eric A Nickel, Joseph Medvec, Kyle Barrons, Spencer Mion, Andrew H Hansen
In recent years, numerous prosthetic ankle-foot devices have been developed to address the demands of sloped walking for individuals with lower-limb amputation. The goal of this study was to compare the performance of a passive, hydraulic ankle-foot prosthesis to two related, non-hydraulic ankles based on their ability to minimize the socket reaction moments of individuals with transtibial amputation during a range of sloped walking tasks. After a two-week accommodation period, kinematic data were collected on seven subjects with a transtibial amputation walking on an instrumented treadmill set at various slopes...
2017: PloS One
https://www.readbyqxmd.com/read/28277993/maggot-therapy-for-wound-care-in-iran-a-case-series-of-the-first-28-patients
#15
A Mirabzadeh, M J Ladani, B Imani, S A B Rosen, R A Sherman
OBJECTIVE: The need for improved wound care is receiving considerable attention in the Islamic Republic of Iran. Beginning in 2003, maggot therapy (MT) became part of Iran's effort to advance its wound care technology. The first cohort of patients treated with MT was analysed to evaluate the use of this treatment. METHOD: Patients treated with MT at three hospitals in Tehran were analysed retrospectively. Primary outcomes were time to wound debridement and time to wound healing...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28274750/the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-predicts-wound-healing-but-not-major-amputation-in-patients-with-diabetic-foot-ulcers-treated-in-a-multidisciplinary-setting
#16
Nestoras Mathioudakis, Caitlin W Hicks, Joseph K Canner, Ronald L Sherman, Kathryn F Hines, Ying W Lum, Bruce A Perler, Christopher J Abularrage
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage 4 WIfI patients, with 1-year amputation rates of 20% to 64%. Our aim was to determine the association between WIfI stage and wound healing and major amputation among patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28273496/ertl-and-non-ertl-amputees-exhibit-functional-biomechanical-differences-during-the-sit-to-stand-task
#17
Abbie E Ferris, Cory L Christiansen, Gary D Heise, David Hahn, Jeremy D Smith
BACKGROUND: People with transtibial amputation stand ~50times/day. There are two general approaches to transtibial amputation: 1) distal tibia and fibula union using a "bone-bridge" (Ertl), 2) non-union of the tibia and fibula (Non-Ertl). The Ertl technique may improve functional outcomes by increasing the end-bearing ability of the residual limb. We hypothesized individuals with an Ertl would perform a five-time sit-to-stand task faster through greater involvement/end-bearing of the affected limb...
February 22, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28271944/an-assessment-of-intralesional-epidermal-growth-factor-for-treating-diabetic-foot-woundsthe-first-experiences-in-turkey
#18
Bulent M Ertugrul, Benjamin A Lipsky, Ulas Guvenc
BACKGROUND: Intralesional epidermal growth factor (EGF) has been available as a medication in Turkey since 2012. We present the results of our experience using intralesional EGF in Turkey for patients with diabetic foot wounds. METHODS: A total of 174 patients from 25 Turkish medical centers were evaluated for this retrospective study. We recorded the data on enrolled individuals on custom-designed patient follow-up forms. Patients received intralesional injections of 75 μg of EGF three times per week and were monitored daily for adverse reactions to treatment...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28271310/evaluation-of-changes-to-foot-shape-in-females-5%C3%A2-years-after-mastectomy-a-case-control-study
#19
Iwona Głowacka-Mrotek, Magdalena Sowa, Zygmunt Siedlecki, Tomasz Nowikiewicz, Wojciech Hagner, Wojciech Zegarski
PURPOSE: The aim of this study was to evaluate changes in foot shape of women 5 years after undergoing breast amputation. METHODS: Evaluation of foot shape was performed using a non-invasive device for computer analysis of the plantar surface of the foot. Obtained results were compared between feet on the healthy breast side (F1) and on the amputated breast side (F2). RESULTS: 128 women aged 63.60 ± 8.83, 5-6 years after breast amputation were enrolled in this case-control study...
March 7, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28269705/real-time-evaluation-of-a-myoelectric-control-method-for-high-level-upper-limb-amputees-based-on-homologous-leg-movements
#20
Kenneth R Lyons, Sanjay S Joshi
Electromyography-based gesture classification methods for control of advanced upper limb prostheses are limited either to individuals with amputations distal to the elbow or to those willing to undergo targeted muscle reinnervation surgery. Based on the natural similarity between gestures of the lower leg and the arm and on established methods in electromyography-based gesture classification, we propose a noninvasive system with which users control an upper limb prosthesis via homologous movements of the leg and foot...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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