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https://www.readbyqxmd.com/read/28448704/-retrograde-intramedullary-nail-fixation-for-charcot-neuroarthropathy
#1
E López-Gavito, N A Gómez-Fuentes, P Parra-Téllez, M Lezama-Peniche, J Vázquez-Escamilla, S R León-Hernández
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28442207/tibio-talo-calcaneal-fusion-after-limb-salvage-procedures-a-retrospective-study
#2
Lukas Zak, Gerald E Wozasek
BACKGROUND: The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28436270/does-physiological-stress-slowdown-wound-healing-in-patients-with-diabetes
#3
Javad Razjouyan, Gurtej Singh Grewal, Talal K Talal, David G Armstrong, Joseph L Mills, Bijan Najafi
BACKGROUND: Poor healing is an important contributing factor to amputation among patients with diabetic foot ulcers (DFUs). Physiological stress may slow wound healing and increase susceptibility to infection. OBJECTIVES: The objective was to examine the association between heart rate variability (HRV) as an indicator of physiological stress response and healing speed (HealSpeed) among outpatients with active DFUs. DESIGN AND METHODS: Ambulatory patients with diabetes with DFUs (n = 25, age: 59...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28435579/peripheral-gangrene-complicating-systemic-lupus-erythematosus-in-a-patient-with-spina-bifida-a-case-report
#4
S Vijay, V K Imthiaz, S Hitesh
An adolescent girl, a known case of spina bifida with systemic lupus, presented with bluish discolouration of three toes of the right foot. She had thrombosis of bilateral popliteal arteries. She underwent percutaneous transluminal angioplasty (PTA) of both legs and Chopart amputation of the right foot. Systemic lupus erythematosus (SLE) occurring in a patient with spina bifida has not been previously reported. Weakness, sensory loss, lack of normal ambulation, endarteritis, antiphospholipid antibody syndrome are common contributory factors for peripheral gangrene in patients with spina bifida with systemic lupus erythematosus...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28424173/association-between-estimated-glomerular-filtration-rate-and-outcomes-in-patients-with-diabetic-foot-ulcers-a-3-year-follow-up-study
#5
Yang He, Hongjie Qian, Lei Xu, Shanshan Zhang, Xueming Gu, Junyi Gu, Jianyuan Shi, Yaping Shen, Jian-Min Liu, Zhengyi Tang
OBJECTIVE: End stage renal disease and dialysis have been proven to be associated with poor prognoses in diabetic foot ulcers (DFU). However, it has rarely been reported whether and to what extent milder renal insufficiency effects the prognosis. The purpose of this study was to investigate the categorized impact of estimated glomerular filtration (eGFR) on the outcomes of patients with DFU. DESIGN AND METHODS: Three hundred and sixty-six DFU patients hospitalized in a Chinese tertiary hospital were recruited and classified into 4 groups according to the eGFRs as follows: normal (≥90), mildly reduced (60-89), moderately reduced (30-59), and severely reduced (<30)...
April 19, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28423369/mdi-301-a-synthetic-retinoid-depressed-levels-of-matrix-metalloproteinases-and-oxidative-stress-in-diabetic-dermal-fibroblasts
#6
Jianhua Zhai, Yuli Wang
Diabetic foot ulcerations could result in serious consequences such as amputations. The up-regulation of matrix metalloproteinases and down-regulation of TIMP1 were remarked as distinctive biological characteristics in the diabetic dermal fibroblast. The current study was performed in order to clarify the effect of high glucose on formation of diabetic dermal fibroblast cell. In addition, the effect of MDI 301 on ameliorating diabetic fibroblasts was investigated in this study. The mRNA and protein expression levels of MMPs, TIMP1 and catalase were evaluated against fibroblasts treated with high glucose (30 mM) using qRT-PCR, western blotting and zymography assays...
April 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28419034/complications-and-functional-outcomes-after-pantalar-dislocation
#7
Kaeleen A Boden, Douglas S Weinberg, Heather A Vallier
BACKGROUND: Pantalar dislocations without associated talar fracture are rare and have high risks of complications, including infection, osteonecrosis, and posttraumatic osteoarthrosis. Limited information on later function exists. This study evaluated complications and outcomes following pantalar dislocation without talar fracture. METHODS: Nineteen patients were identified with open (n = 14) or closed (n = 5) pantalar dislocations without talar fracture. Ten male and 9 female patients with a mean age of 39...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28417873/trends-in-the-incidence-of-lower-limb-amputation-after-implementation-of-a-multidisciplinary-diabetic-foot-unit
#8
Sara Jiménez, José Antonio Rubio, Julia Álvarez, Fernando Ruiz-Grande, Carlos Medina
BACKGROUNDS AND OBJECTIVE: Incidence of lower extremity amputations (LEA) in the population with and without diabetes mellitus (DM) was assessed after implementation of a Multidisciplinary Diabetic Foot Unit (MDFU) during 2008. MATERIAL AND METHODS: Non-traumatic LEA were analyzed, and those performed before (2001-2007) and after (2008-2014) introduction of the MDFU were compared. LEA were grouped by age and sex. Their incidence was expressed as a rate per 100,000 population per year, adjusted to the standard European population...
April 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28410924/society-for-vascular-surgery-wound-ischemia-foot-infection-wifi-score-correlates-with-the-intensity-of-multimodal-limb-treatment-and-patient-centered-outcomes-in-patients-with-threatened-limbs-managed-in-a-limb-preservation-center
#9
William P Robinson, Lorraine Loretz, Colleen Hanesian, Julie Flahive, John Bostrom, Nicholas Lunig, Andres Schanzer, Louis Messina
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. METHODS: We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015)...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28395911/a-predictive-model-of-anxiety-and-depression-symptoms-after-a-lower-limb-amputation
#10
Susana Pedras, Rui Carvalho, M Graça Pereira
BACKGROUND: Patients with Diabetic Foot Ulcer (DFU) show high levels of depression and anxiety symptoms. The loss of a limb is undoubtedly a devastating experience and several studies have shown that anxiety and depression symptoms are a common reaction after a lower limb amputation (LLA). However, no study has focused on the immediate emotional reactions to LLA as a personal factor based on the ICF Model. OBJECTIVE: This study focused on the characterization of anxiety and depression levels, before and after surgery, differences in levels of depression and anxiety before and after surgery and the predictors of anxiety and depression one month after surgery, in a sample of patients with DFU...
March 27, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28393971/-mechanical-and-pharmacomechanical-trombolysis-in-deep-venous-thrombosis-with-no-clinical-response-to-conventional-treatment
#11
Leopoldo Marine, Jesús Urbina, Michel Bergoeing, Francisco Valdés, Renato Mertens, Albrecht Kramer
BACKGROUND: Conventional treatment of deep vein thrombosis (DVT) is anticoagulation, bed rest and limb elevation. Proximal DVT patients with persisting edema, pain and cyanosis of extremities despite of conventional therapy may develop ischemia. Direct treatment of thrombosis becomes necessary. AIM: To report our experience with mechanical trombolysis of proximal lower extremity DVT. MATERIAL AND METHODS: Retrospective review of medical records of proximal DVT patients treated with thrombolysis between March 2012 and August 2015...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28386568/mesenchymal-stem-cells-improve-healing-of-diabetic-foot-ulcer
#12
REVIEW
Yue Cao, Xiaokun Gang, Chenglin Sun, Guixia Wang
Mesenchymal stem cells (MSCs), an ideal cell source for regenerative therapy with no ethical issues, play an important role in diabetic foot ulcer (DFU). Growing evidence has demonstrated that MSCs transplantation can accelerate wound closure, ameliorate clinical parameters, and avoid amputation. In this review, we clarify the mechanism of preclinical studies, as well as safety and efficacy of clinical trials in the treatment of DFU. Bone marrow-derived mesenchymal stem cells (BM-MSCs), compared with MSCs derived from other tissues, may be a suitable cell type that can provide easy, effective, and cost-efficient transplantation to treat DFU and protect patients from amputation...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28382211/paraplegia-and-transtibial-amputation-successful-ambulation-after-dual-disability-a-retrospective-case-report
#13
Thangavelu Senthilvelkumar, Bobeena R Chandy
INTRODUCTION: This is a single-subject case report. The objective is to describe the unique rehabilitation outcome of an individual with motor complete T12 paraplegia and a right transtibial amputation. This study was conducted at the Department of Physical Medicine and Rehabilitation of Christian Medical College in India. CASE PRESENTATION: A 42-year-old policeman presented to our rehabilitation centre with motor complete T12 paraplegia and right transtibial amputation, 3 months following a road traffic accident...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28360503/the-role-of-copy-and-paste-function-in-orthopedic-trauma-progress-notes
#14
Wesley Winn, Irshad A Shakir, Heidi Israel, Lisa K Cannada
INTRODUCTION: The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. METHODS: IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28356555/prevalence-of-polymorphisms-in-opg-rankl-and-rank-as-potential-markers-for-charcot-arthropathy-development
#15
Bożena Bruhn-Olszewska, Anna Korzon-Burakowska, Grzegorz Węgrzyn, Joanna Jakóbkiewicz-Banecka
Charcot arthropathy is one of the most serious complications of diabetic foot syndrome that leads to amputation of the affected limb. Since there is no cure for Charcot arthropathy, early diagnosis and implementation preventive care are the best available treatment. However, diagnosis is hindered by obscure clinical picture of the disease and lack of molecular markers for its early detection. Results of recent research suggest that OPG-RANKL-RANK axis regulating bone metabolism can be associated with Charcot arthropathy and that SNPs in OPG gene are associated with the disease...
March 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28346194/case-report-diabetic-foot-ulcer-infection-treated-with-topical-compounded-medications
#16
Kelechi E Agbi, Maria Carvalho, Ha Phan, Cristiane Tuma
An adult diabetic male with three toes amputated on his right foot presented with an ulcer infection on his left foot, unresponsive to conventional antifungal oral medication for over two months. The ulcerated foot wound had a large impairment on the patient's quality of life, as determined by the Wound-QoL questionnaire. The compounding pharmacist recommended and the physician prescribed two topical compounded medicines, which were applied twice a day, free of charge at the compounding pharmacy. The foot ulcer infection was completely resolved following 13 days of treatment, with no longer any impairment on the patient's quality of life...
January 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#17
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
March 21, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28340359/diabetic-foot-ulcer-development-risk-classifications-validation-a-multicentre-prospective-cohort-study
#18
M Monteiro-Soares, R Ribas, C Pereira da Silva, T Bral, A Mota, S Pinheiro Torres, A Morgado, R Couceiro, R Ribeiro, V Dias, M Moreira, P Mourão, M J Oliveira, M Madureira, V Paixão-Dias, M Dinis-Ribeiro
AIMS: To prospectively validate the existing classifications to stratify subjects with diabetes mellitus (DM) by their risk of diabetic foot ulcer (DFU), in high and low risk settings. METHODS: A prospective multicentre cohort study was conducted, including 446 subjects with DM without active DFU followed in the hospital or primary care setting. Demographic, clinical characterization variables, and those included in the classifications were collected at baseline...
March 9, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28326825/role-of-biomarkers-in-predicting-diabetes-complications-with-special-reference-to-diabetic-foot-ulcers
#19
Sivakamasundari Pichu, Bhoomika M Patel, Subbu Apparsundaram, Ramesh K Goyal
Diabetic foot ulcer (DFU) is one of the major complications of diabetes and about 1% of people with diabetes have to go for lower limb amputation. With better understanding of the pathological basis of DFU, number of biomarkers like atrial natriuretic peptides, galectin-3, and cardiac troponins for diabetic cardiomyopathy, cystatin C for diabetics nephropathy and C-reactive protein for infection and procalcitonin could aid in early and noninvasive diagnosis especially when clinical signs are misleading. Predictive role of novel biomarkers in primary prevention however, requires additional studies considering sex, age and multiple complications in DFU...
April 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#20
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
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