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Ulcers orthopedic

Kohta Ito, Kosuke Maeda, Ikumi Fujiwara, Koh Hosoda, Takeo Nagura, Taeyong Lee, Naomichi Ogihara
To clarify the mechanism underlying the development of foot disorders such as diabetic ulcers and deformities, it is important to understand how the foot surface elongates and contracts during gait. Such information is also helpful for improving the prevention and treatment of foot disorders. We therefore measured temporal changes in the strain distribution on the foot surface during human walking. Five adult male participants walked across a glass platform placed over an angled mirror set in a wooden walkway at a self-selected speed and the dorsolateral and plantar surfaces of the foot were filmed using two pairs of synchronized high-speed cameras...
December 18, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Paolo Chiari, Cristiana Forni, Monica Guberti, Domenica Gazineo, Sabrina Ronzoni, Fabio D'Alessandro
BACKGROUND: Older adult patients with fragility hip fractures constitute a population at high risk for complications, in particular pressure ulcers. The aim was to evaluate the incidence of pressure ulcers and potential predictive factors. METHODS AND FINDINGS: A prospective multicentric prognostic cohort study in orthopedic wards in three Italian public hospitals. Participants were all consecutive patients 65 years of age or older diagnosed with a fragility hip fracture...
2017: PloS One
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
Hans Rutberg, Madeleine Borgstedt-Risberg, Pelle Gustafson, Maria Unbeck
BACKGROUND: The national incidence of adverse events (AEs) in Swedish orthopedic care has never been described. A new national database has made it possible to describe incidence, nature, preventability and consequences of AEs in Swedish orthopedic care. METHODS: We used national data from a structured two-stage record review with a Swedish modification of the Global Trigger Tool. The sample was 4,994 randomly selected orthopedic admissions in 56 hospitals during 2013 and 2014...
2016: Patient Safety in Surgery
Jill Cox, Loretta Kaes, Miguel Martinez, Daniel Moles
Skin temperature may help prospectively determine whether an area of skin discoloration will evolve into necrosis. A prospective, observational study was conducted in 7 skilled nursing facilities to determine if skin temperature measured using infrared thermography could predict the progression of discolored intact skin (blanchable erythema, Stage 1 pressure ulcer, or sus- pected deep tissue injury [sDTI]) to necrosis and to evaluate if nurses could effectively integrate thermography into the clinical setting...
October 2016: Ostomy/wound Management
Siham Zahi, Laila Mahir, Soumia Meftah, Fatima Lmidmani, Abdellatif El Fatimi
OBJECTIVE: Premature aging syndromes are very rare and most often hereditary. Initially purely descriptive entities, these syndromes are now much better understood genetically and pathophysiologically and can now be classified according to the mechanisms involved. They often manifest as a pigmented skin dry, atrophic and sclerotic. There is no treatment for these conditions apart from that of their complications (frequent ulceration). OBSERVATIONS: Forty-five years of patient follow-up in dermatology for premature aging syndrome, addressed in our service for podiatric care...
September 2016: Annals of Physical and Rehabilitation Medicine
Marion Prigent, Sylvain Brochard, Mathias Thepaut, Christian Lefèvre, Dominique Le Nen, Thierry Cornic, Marie-Thérèse Cariou, Catherine Le Rouzic, Phlippe Le Moine, Christelle Pons, Laetitia Houx
OBJECTIVE: Traumatic lower limb amputation is rare in pediatric population, and surgeons always try limb salvage. But rarely, later amputation occurred when the traumatic limb is painful. It is a difficult and irreversible decision needed a multidisciplinary approach. We report how we managed a programmed trans-tibial amputation on 13-years-old boy, 20 months after a foot trauma. OBSERVATIONS: Our patient is an adolescent victim of a left foot crash. The first checkup showed a degloving injury, dislocation of the interphalangeal joints and of all toes...
September 2016: Annals of Physical and Rehabilitation Medicine
E López-Gavito, P Parra-Téllez, J Vázquez-Escamilla
Diabetes mellitus is a major chronic degenerative disease, which currently is taking on alarming proportions in the population of our country. Neuropathic arthropathy is one of the most interesting degenerative joint disorders and increasingly common within the orthopedic pathology. It is defined as a progressive degenerative arthropathy, chronic and affecting one or more peripheral joints, and develops as a result of the lack of sensory perception normal in the innervation of joints. As a result the joints of the feet are subjected to trauma and repetitive injury causing a neurotraumatic effect with progressive damage to the joints of the hindfoot, midfoot and forefoot...
January 2016: Acta Ortopédica Mexicana
Kaitlyn Bernhard, Kenneth Morgan, Dustin Kruse, Paul A Stone
Marjolin's ulcer is a rare and aggressive cutaneous malignancy arising from previously traumatized skin, most commonly at the site of previous burns. We present a unique case of Marjolin's ulceration secondary to an orthopedic injury and a nonburn history of trauma. The patient had been involved in a motorcycle accident >20 years earlier. For 17 months, the patient had refused to acknowledge the severity of his disease state. He had refused the standard of care and opted for local wound care only until a minor fall caused a pathologic fracture, leading to an above the knee amputation...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Roslyn J Miller
Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot...
September 2016: Foot and Ankle Clinics
Sarah Malacarne, Bernhard Chappuis, Marc Egli, Isabelle Hagon-Traub, Katrin Schimke, Claude Schönenweid, Bettina Peter-Riesch
Diabetic foot complications are a public health challenge and preventive measures although simple are often not enforced, as evidenced by the lack of decrease in the rate of ulcers and amputation in Switzerland. This article proposes a risk score to grade individual risk of the diabetic patient and an individualized prevention measures as this risk. We discuss the importance of collaboration of various specialists. Two areas are important, first the early involvement of specialists in revascularization because the diabetic population with feet at risk of ulcération risk nowadays primarily has neuro-ichemic ulcerations and also the close collaboration with podiatrists and orthopedic shoemakers who are full partners of the multidisciplinary team...
June 1, 2016: Revue Médicale Suisse
Talita Stessuk, Maria Beatriz Puzzi, Elinton Adami Chaim, Paulo César Martins Alves, Erich Vinicius de Paula, Andresa Forte, Juliana Massae Izumizawa, Carolina Caliári Oliveira, Fernando Frei, João Tadeu Ribeiro-Paes
The clinical use of tissue engineering associated with cell therapy is considered a new alternative therapy for the repair of chronic lesions with potential application in different medical areas, mostly in orthopedic and dermatological diseases. Platelet-rich plasma (PRP) is a rich source of growth factors and cytokines important for wound healing. Adipose-derived mesenchymal stem cells (ADSCs) have shown potential to accelerate the resolution of ulcers, to stimulate cell proliferation, and to benefit the quality of skin repair...
September 2016: Archives of Dermatological Research
Haiyan Xie, Nancye M Peel, John P Hirdes, Jeff W Poss, Leonard C Gray
OBJECTIVES: To validate the Pressure Ulcer Risk Scale (PURS) to screen for pressure ulcer (PU) outcomes in the acute hospital setting. DESIGN: Secondary data analysis was undertaken using a combined dataset from three prospective cohort studies. SETTING: General medical, surgical, and orthopedic wards in 11 hospitals in two states of Australia. PARTICIPANTS: Individuals aged 70 and older admitted to the hospital for longer than 48 hours from July 2005 to May 2010 (N = 1418)...
June 2016: Journal of the American Geriatrics Society
Nicole M Coomer, Amy M G Kandilov
BACKGROUND: Hospital-acquired conditions (HACs) can increase the financial liabilities faced by patients when the HACs require additional treatment both in the hospital and in subsequent health care encounters. This article estimates incremental effects of 6 HACs on Medicare beneficiary financial liabilities. METHODS: Descriptive and multivariate analyses were used to examine the differences in beneficiary liability between care episodes with and without HACs. Episodes included the index hospitalization in which the HAC occurred and all inpatient, outpatient, and physician claims within 90 days of index hospital discharge...
May 9, 2016: American Journal of Infection Control
Rose Ekama Ilesanmi, Odunayo Morohunfoluwa Oluwatosin
Educational intervention programs are an important element to improve nurses' knowledge of pressure ulcer (PU) prevention. Various teaching methods have been used with diverse results but none have been analyzed in Nigeria. A quasi- experimental study using a pretest/post test design was conducted among 193 registered nurses with >6 months experience who worked in purposefully selected wards (neuroscience, orthopedics, renal, and cardiac) in 3 teaching hospitals to examine the level of knowledge retention after interactive instruction...
April 2016: Ostomy/wound Management
Nobuaki Suzuki, Katsumitsu Arai, Saizo Kon, Kayo Yamanaka, Hiroshi Otsuka, Masahiro Koizumi, Noboru Hosaka, Masahiko Tsuchiya, Tomoharu Mochizuki, Tatsuya Kuraishi, Takayuki Murayama, Hideki Tashi, Naoki Oike, Masashi Wakasugi, Yuki Takahashi, Masato Nakadai, Naoto Endo
The Niigata Prefectural Central Hospital (NPCH) is one of the main hospitals for the cities of Joetsu and Myoko, Niigata Prefecture, Japan, an area with a population of 240,141, of whom 26.7 % were aged ≥65 years in 2009. In the NPCH, patients with hip fractures are admitted to an orthopedic ward within 4 h, 89.2 % of patients are operated on within 48 h during working hours, and the prevalence of pressure ulcers is 1.5 %. To reduce the incidence of hip fractures, two major challenges emphasizing secondary fracture prevention were initiated in 2012...
March 30, 2016: Journal of Bone and Mineral Metabolism
O V Galimov, V O Khanov, R R Saifullin, G R Valieva, V P Okroyan
The article presents the results of treatment of 201 patients with neuroischemic form of diabetic foot syndrome. The research included 158 women and 43 men of the middle age of 62.5 ± 11.2 years. The complex approach was applied in treatment including medicamentous treatment, revasculization of extremity, an application of modern combined collagenous coating and foot relieving using silicone insoles and orthopedic footwear. The endovascular and open reconstructive operations were performed in order to obtain the revasculization of extremity...
2015: Vestnik Khirurgii Imeni I. I. Grekova
Y S Siddiqui, M K A Sherwani, A Q Khan, M Zahid, M Abbas, N Asif
BACKGROUND: Management of malignant bone and soft tissue tumors remains an overwhelming confront to orthopedic surgeons. The challenge is discriminating in developing countries due to inadequate diagnostic and therapeutic amenities and unawareness. A lot has been discussed about the neglected orthopedic trauma, but the published literature on the causes and management of neglected bone and soft tissue tumors is sparse. Hence, current study was undertaken to highlight the causes of neglect and therapeutic challenges for managing these neglected tumors in developing countries...
July 2015: Indian Journal of Cancer
Mari Shimizu, Hajime Matsumine, Masaki Takeuchi
A 63-year-old man dropped a metal chunk onto his left foot during his work and suffered a crush injury of the left forefoot. He underwent Chopart's amputation followed by stump coverage with sole skin at the orthopedic department on the same day. He was referred to our department for reconstruction because of poor vascularization and subsequent necrosis of tissue at the stump. After the necrotic tissue was debrided, exposure of the talus bone was noted. An artificial dermis was then applied to the stump wound, followed by local negative pressure wound therapy...
November 2015: Plastic and Reconstructive Surgery. Global Open
R Schuh, R Windhager
The use of inserts and orthopedic shoe adjustment represents an essential component of the conservative therapy of degenerative diseases and deformities of the musculoskeletal system. Inserts can have supportive, bedding and corrective effects and are used in particular for complaints of the feet and ankles. The combination of diverse materials allows a high level of cushioning and supporting features and corresponding longevity to be accomplished. The production is carried out on an individual basis and if necessary computer-assisted in order to achieve an optimal fit...
March 2016: Der Orthopäde
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