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Foot amputation

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https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#1
REVIEW
Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27902390/virulence-determinants-in-clinical-staphylococcus-aureus-from-monomicrobial-and-polymicrobial-infections-of-diabetic-foot-ulcers
#2
Kavitha Shettigar, Spoorthi Jain, Deepika V Bhat, Raviraj Acharya, Lingadakai Ramachandra, Kapaettu Satyamoorthy, T S Murali
Antibiotic resistance in Staphylococcus aureus is a major public health concern and Methicillin Resistant S. aureus has emerged as an important pathogen. We characterized S. aureus isolates from monomicrobial and polymicrobial wound infections from 200 diabetic individuals with foot ulcers to understand their underlying diversity and pathogenicity. Staphylococcal Cassette Chromosome mec typing was performed and genes coding for production of biofilm, Panton-Valentine Leukocidin, Toxic Shock Syndrome Toxin, Leukotoxins DE and M were screened...
October 19, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27898266/methicillin-resistant-staphylococcus-aureus-in-foot-osteomyelitis
#3
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/27897738/a-preventable-disaster
#4
Jennifer Trueland
When Ruth Miller looks at the latest figures on diabetes-related foot amputations, she admits that her heart sinks a little. As Poole NHS Foundation Trust's lead diabetes nurse, she knows the devastation the disease can wreak on people's feet. Yet this message does not seem to be getting through.
November 16, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27890336/complications-and-revision-amputation-following-trauma-related-lower-limb-loss
#5
Eric Edison Low, Elizabeth Inkellis, Saam Morshed
INTRODUCTION: Trauma-related amputations are a common cause of limb loss in the United States. Despite the military and public health impact of trauma-related amputations, distributions of various lower limb amputations and the relative frequency of complications and revision amputations have not been well described. We used the National Trauma Data Bank (NTDB) in order to investigate the epidemiology of trauma-related lower extremity amputations among civilians in U.S. trauma centers...
November 18, 2016: Injury
https://www.readbyqxmd.com/read/27888847/mr-imaging-of-the-diabetic-foot
#6
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/27888790/complication-assessment-and-prevention-strategies-using-midfoot-fusion-bolt-for-medial-column-stabilization-in-charcot-s-osteoarthropathy
#7
Alexander T Mehlhorn, Markus Walther, Niklas Iblher, Norbert P Südkamp, Hagen Schmal
In Charcot's osteoarthropathy stabilization of the medial column of the foot was introduced in order to establish a stable foot and reduce the risk for amputation. This study was performed to analyze postoperative complications, define risk factors for those and develop strategies for prevention. Since bolt dislocation takes place frequently, it was aimed to predict an appropriate time point for bolt removal under the condition that osseous healing has occurred. Fourteen consecutive patients with neuroosteoarthropathy of the foot and arch collapse were treated with open reduction and stabilization using midfoot fusion bolt and lateral lag screws...
November 4, 2016: Foot
https://www.readbyqxmd.com/read/27887858/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-diabetic-wound-healing
#8
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Robert B McLafferty, Nabil J Alkayed, Gregory L Moneta, Amir F Azarbal
OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds. METHODS: The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27881551/comparison-of-the-otto-bock-solid-ankle-cushion-heel-foot-with-wooden-keel-to-the-low-cost-cr-equipements%C3%A2-solid-ankle-cushion-heel-foot-with-polypropylene-keel-a-randomized-prospective-double-blind-crossover-study-assessing-patient-satisfaction-and-energy
#9
Alain Lacraz, Stéphane Armand, Katia Turcot, Gorki Carmona, Richard Stern, Olivier Borens, Mathieu Assal
BACKGROUND: The International Committee of the Red Cross supports a worldwide program of prosthetic fitting and rehabilitation. In this context, a prosthetic foot was developed and widely distributed in least developed countries. STUDY DESIGN: Prospective, randomized, double-blind, controlled study. OBJECTIVE: To compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (CR-Equipements(™) solid ankle cushion heel, International Committee of the Red Cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot, Otto Bock)...
November 22, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#10
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
#11
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/27849466/descriptive-characteristics-and-amputation-rates-with-use-of-intrepid-dynamic-exoskeleton-orthosis
#12
Owen Hill, Lakmini Bulathsinhala, Susan L Eskridge, Kimberly Quinn, Daniel J Stinner
Advancements in ankle-foot orthotic devices, such as the Intrepid Dynamic Exoskeletal Orthosis (IDEO), are designed to improve function and reduce pain of the injured lower extremity. There is a paucity of research detailing the demographics, injury patterns and amputation outcomes of patients who have been prescribed an IDEO. The purpose of this study was to describe the demographics, presenting diagnosis and patterns of amputation in patients prescribed an IDEO at the Center for the Intrepid (CFI). The study population was comprised of 624 service members who were treated at the CFI and prescribed an IDEO between 2009 and 2014...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849465/outcomes-associated-with-the-intrepid-dynamic-exoskeletal-orthosis-ideo-a-systematic-review-of-the-literature
#13
M Jason Highsmith, Leif M Nelson, Neil T Carbone, Tyler D Klenow, Jason T Kahle, Owen T Hill, Jason T Maikos, Mike S Kartel, Billie J Randolph
High-energy lower extremity trauma is a consequence of modern war and it is unclear if limb amputation or limb salvage enables greater recovery. To improve function in the injured extremity, a passive dynamic ankle-foot orthosis, the Intrepid Dynamic Exoskeletal Orthosis (IDEO), was introduced with specialized return to run (RTR) therapy program. Recent research suggests, these interventions may improve function and return to duty rates. This systematic literature review sought to rate available evidence and formulate empirical evidence statements (EESs), regarding outcomes associated with IDEO utilization...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849461/differences-in-military-obstacle-course-performance-between-three-energy-storing-and-shock-adapting-prosthetic-feet-in-high-functioning-transtibial-amputees-a-double-blind-randomized-control-trial
#14
M Jason Highsmith, Jason T Kahle, Rebecca M Miro, Derek J Lura, Stephanie L Carey, Matthew M Wernke, Seok Hun Kim, William S Quillen
BACKGROUND: Approximately 683 persons engaged in military service experienced transtibial amputation (TTA) related to recent war in Iraq and Afghanistan. Military TTAs function at a level beyond basic ambulation. No empirical data demonstrate which higher functioning prosthetic feet maximize injured service personnel's ability to continue performing at a level commensurate with return to duty. This study's purpose was to determine which of three high-functioning, energy-storing prosthetic feet maximize performance and preference in a field obstacle course (OC) and to quantify physical performance differences between TTAs and high-functioning nonamputees...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849290/the-prevention-of-diabetic-foot-ulceration-how-biomechanical-research-informs-clinical-practice
#15
Frank E DiLiberto, Judith F Baumhauer, Deborah A Nawoczenski
Background: Implementation of interprofessional clinical guidelines for the prevention of neuropathic diabetic foot ulceration has demonstrated positive effects regarding ulceration and amputation rates. Current foot care recommendations are primarily based on research regarding the prevention of ulcer recurrence and focused on reducing the magnitude of plantar stress (pressure overload). Yet, foot ulceration remains to be a prevalent and debilitating consequence of Diabetes Mellitus...
November 16, 2016: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/27846299/hyperglycemia-induces-skin-barrier-dysfunctions-with-impairment-of-epidermal-integrity-in-non-wounded-skin-of-type-1-diabetic-mice
#16
Junko Okano, Hideto Kojima, Miwako Katagi, Takahiko Nakagawa, Yuki Nakae, Tomoya Terashima, Takeshi Kurakane, Mamoru Kubota, Hiroshi Maegawa, Jun Udagawa
Diabetes causes skin complications, including xerosis and foot ulcers. Ulcers complicated by infections exacerbate skin conditions, and in severe cases, limb/toe amputations are required to prevent the development of sepsis. Here, we hypothesize that hyperglycemia induces skin barrier dysfunction with alterations of epidermal integrity. The effects of hyperglycemia on the epidermis were examined in streptozotocin-induced diabetic mice with/without insulin therapy. The results showed that dye leakages were prominent, and transepidermal water loss after tape stripping was exacerbated in diabetic mice...
2016: PloS One
https://www.readbyqxmd.com/read/27843849/a-study-of-risk-factors-and-foot-care-behavior-among-diabetics
#17
Mackson Nongmaithem, Arjinder Pal Singh Bawa, Abhilash Kumar Pithwa, Simran Kaur Bhatia, Gurjit Singh, Somnath Gooptu
BACKGROUND: Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27843662/neck-of-femur-fracture-in-a-patient-with-a-chronic-osteomyelitis-of-the-ipsilateral-foot
#18
Anne-Carolin Döring, Anne J H Vochteloo, Kees van Doorn, Rianne M H A Huis In 't Veld, Anil Peters
This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27827300/concordance-in-diabetic-foot-ulceration-a-cross-sectional-study-of-agreement-between-wound-swabbing-and-tissue-sampling-in-infected-ulcers
#19
E Andrea Nelson, Alexandra Wright-Hughes, Sarah Brown, Benjamin A Lipsky, Michael Backhouse, Moninder Bhogal, Mwidimi Ndosi, Catherine Reynolds, Gill Sykes, Christopher Dowson, Michael Edmonds, Peter Vowden, Edward B Jude, Tom Dickie, Jane Nixon
BACKGROUND: There is inadequate evidence to advise clinicians on the relative merits of swabbing versus tissue sampling of infected diabetic foot ulcers (DFUs). OBJECTIVES: To determine (1) concordance between culture results from wound swabs and tissue samples from the same ulcer; (2) whether or not differences in bacterial profiles from swabs and tissue samples are clinically relevant; (3) concordance between results from conventional culture versus polymerase chain reaction (PCR); and (4) prognosis for patients with an infected DFU at 12 months' follow-up...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27826906/amputation-and-rotationplasty-in-children-with-limb-deficiencies-current-concepts
#20
REVIEW
Ralph Sakkers, Iris van Wijk
PURPOSE: Amputations and fitting surgery have a long history in children with limb deficiencies. With the current developments in limb reconstruction and new techniques in prosthetics, the indications for amputation and fitting surgery might have shifted, but still have a very important role in creating high functional performance, optimal participation and quality of life. The purpose of this current concepts article is to give an overview of the indications, dilemmas and technical considerations in the decision-making for amputation and fitting surgery...
November 8, 2016: Journal of Children's Orthopaedics
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