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osteomyelitis foot

Mesut Mutluoglu, Benjamin A Lipsky
No abstract text is available yet for this article.
October 17, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Ashu Rastogi, Anish Bhattacharya, Mahesh Prakash, Sarika Sharma, Bhagwant R Mittal, Niranjan Khandelwal, Anil Bhansali
OBJECTIVE: Diabetic foot osteomyelitis (DFO) is difficult to diagnose in the presence of Charcot's neuroarthropathy (CN) and bone biopsy is not always possible. We aimed to assess the efficacy of PET/computed tomography using F-fluoride (F-fluoride PET/CT) and fluorine-18-fluorodeoxyglucose-labeled autologous leukocytes (F-FDG-LL PET/CT) in comparison with contrast-enhanced MRI (CEMRI) for the detection of DFO. PATIENTS AND METHODS: Thirty-two patients with chronic CN and foot ulcer suspected of having DFO were prospectively evaluated...
October 4, 2016: Nuclear Medicine Communications
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
John Vorrasi, Geoffrey Zinberg
Parotitis is a common occurrence in the immunocompromised, dehydrated, and malnourished patient as a result of dysfunctional ductal and parotid cells. Inflammation can be acute or chronic based on clinical history, and it can be suppurative based on the presence of micro or macro abscess formation within the substance of the gland. This report presents a case of concomitant condylar osteomyelitis and chronic suppurative parotitis in the setting of previous methicillin-susceptible Staphylococcus aureus foot infection...
September 13, 2016: Journal of Oral and Maxillofacial Surgery
Luca Dalla Paola, Anna Carone, Giulio Boscarino, Giuseppe Scavone, Lucian Vasilache
Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator...
September 29, 2016: International Journal of Lower Extremity Wounds
S Fiquet, F Desbiez, I Tauveron, N Mrozek, M Vidal, O Lesens
OBJECTIVE: We aimed to develop and implement an application that could improve the management of patients presenting with diabetic foot osteomyelitis. PATIENTS AND METHODS: Physicians from the multidisciplinary diabetic foot infection team and a software engineer first assessed the needs required for the infection management and application. An experimental version was then designed and progressively improved. A final version was implemented in clinical practice in 2013 by the multidisciplinary diabetic foot infection team of our university hospital...
September 28, 2016: Médecine et Maladies Infectieuses
Hyun Suk Suh, Tae Suk Oh, Ho Seung Lee, Seung Hwan Lee, Yong Pil Cho, Joong Ryul Park, Joon Pio Hong
BACKGROUND: Major vessels in the diabetic foot are often calcified and inadequate for use as recipient vessels. Thus, a supermicrosurgery technique using small branches or perforators from other collateral vessels with an adequate pulse may be an alternative method. This study evaluated outcome using the supermicrosurgery concept and the risk factors involved. METHODS: Ninety-five cases of diabetic foot reconstruction were reviewed; the average patient age was 57 years; average follow-up was 43...
October 2016: Plastic and Reconstructive Surgery
Stephen J Kriger, Shontal A Behan, Parth J Bhakta, Nicholas G Bruning, Brennan A Menninger, Mark C Razzante
INTRODUCTION AND OBJECTIVES: Due to its inert character and desired biocompatibility, titanium (Ti) implants have been universally accepted as safer alternatives to the previous conventional orthopedic hardware implants. However, a recent emergence of Type IV hypersensitivity reactions to Ti have displayed symptoms that include eczema, contact dermatitis, prolonged fever, sterile osteomyelitis, and impaired fracture and wound healing. The following case presents a patient with postoperative incision dehiscence and devascularization of cortical surfaces in contact with Ti hardware after undergoing a medial displacement calcaneal osteotomy and a first metatarsal-cuneiform arthrodesis...
September 2016: Journal of the American Podiatric Medical Association
Sneha A Patel, Jackeline Iacovella, Rhonda S Cornell
INTRODUCTION AND OBJECTIVES: Corynebacterium striatum (C. striatum) is known to colonize the skin and mucous membranes of most normal human hosts. While it is frequently isolated in clinical laboratories, the clinical significance of C. striatum is often unknown with respect to diabetic foot infections with osteomyelitis. There have been very few studies published on this topic, and even fewer that report on treatment courses. To our knowledge, there has been no study published reporting diabetic foot osteomyelitis with isolation of C...
September 2016: Journal of the American Podiatric Medical Association
Jean-Philippe Rasigade, Catherine Dunyach-Rémy, Anaïs Sapin, Nourredine Messad, Sophie Trouillet-Assant, Céline Dupieux, Jean-Philippe Lavigne, Frédéric Laurent
The mechanisms that drive the transition from commensality to invasiveness in Staphylococcus aureus are poorly understood. We recently reported that >50% of S. aureus isolates from uninfected diabetic foot ulcers in French patients harbor a prophage, namely ROSA-like, which is absent from invasive isolates from diabetic foot infections including osteomyelitis. Here we show that ROSA-like insertion abolishes the ability of S. aureus to replicate within osteoblasts, the bone-forming cells, greatly reducing damage to infected cells...
September 16, 2016: Journal of Infectious Diseases
Troy J Boffeli, Steven R Smith, Kyle W Abben
Nonhealing wounds along the fifth metatarsal associated with neuropathy and bone deformity frequently become complicated with osteomyelitis. Our surgical technique for complete fifth ray amputation with peroneal tendon transfer has been previously published. The present study evaluated the outcomes regarding success with initial healing and intermediate-term limb survival after this procedure, which is intended to resolve infection, remove bone deformity, heal and prevent recurrence of lateral column wounds, and maintain functional stability of the foot...
September 1, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Neal R Barshes, Cezarina Mindru, Chester Ashong, Maria Rodriguez-Barradas, Barbara W Trautner
We sought to identify factors associated with treatment failure and leg amputations among those patients who presented with foot osteomyelitis. Characteristics, treatments, and outcomes for all patients treated for probable or definite foot osteomyelitis (per consensus definition) between January 2011 and March 2015 were reviewed. Multivariate Cox regression models were used to identify risk factors for treatment failure (unanticipated resection of additional bone or leg amputation) and of leg amputation alone...
August 31, 2016: International Journal of Lower Extremity Wounds
Javier La Fontaine, Kavita Bhavan, Kenrick Lam, Suzanne Van Asten, William Erdman, Lawrence A Lavery, Orhan K Öz
OBJECTIVE: Magnetic resonance imaging (MRI) is the recommended diagnostic imaging technique for diabetic foot osteomyelitis (DFO), with a reported accuracy of 79%. The gold standard to diagnose osteomyelitis is bone biopsy, with a positive culture and/or histopathology findings consistent with osteomyelitis. The purposes of this study are to assess the accuracy of technetium-99m (Tc-99m) labeled white blood cell (WBC) single-photon emission computed tomography/computed tomography (SPECT/CT) hybrid imaging for diagnosing DFO confirmed by bone biopsy and to compare that to the diagnostic accuracy of an MRI...
August 2016: Wounds: a Compendium of Clinical Research and Practice
Dane K Wukich, Kimberlee B Hobizal, Tresa L Sambenedetto, Kristin Kirby, Bedda L Rosario
BACKGROUND: This study was conducted to evaluate the outcomes of patients with diabetic foot osteomyelitis (DFO) compared to diabetic foot soft tissue infections (STIs). METHODS: 229 patients who were hospitalized with foot infections were retrospectively reviewed, identifying 155 patients with DFO and 74 patients with STI. Primary outcomes evaluated were the rates of amputations and length of hospital stay. DFO was confirmed by the presence of positive bone culture and/or histopathology...
August 22, 2016: Foot & Ankle International
Christopher L Camp, Bernard F Morrey, Robert T Trousdale
BACKGROUND: Formalized training in the specialty of orthopedic surgery began at the Mayo Clinic nearly 100 years ago, and treatment of patients with musculoskeletal injuries and disease began even earlier. A robust historical patient database provides the opportunity for review of the first recorded orthopedic cases at our institution, which date back to 1907. METHODS: The first 400 sequential medical charts of the Mayo Clinic's patient record database were comprehensively reviewed in order to identify the first documented orthopedic cases...
2016: Iowa Orthopaedic Journal
D H B Ubayawansa, W Y M Abeysekera, M M A J Kumara
OBJECTIVE: To determine the epidemiology and conditions frequently seen in major lower extremity amputation. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Teaching Hospital Karapitiya, Sri Lanka, from October 2013 to September 2014. METHODOLOGY: Major lower limb amputations were identified according to ICD-10 criteria. Data was retrospectively collected. Type of the amputation, indication for the amputation, gender and age of the patients, and mortality were noted...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Mehtap Evran, Murat Sert, Tamer Tetiker, Gamze Akkuş, Ömer Sunkar Biçer
Spontaneous calcaneal fractures in diabetic patients without obvious trauma may occur, sometimes accompanying diabetic foot ulcers. In the current study we report four cases who were hospitalized for diabetic foot ulcer with concomitant calcaneal fractures. There were four diabetic patients (one type 1 and three type 2) who registered with diabetic foot ulcers with coexisting calcaneal fractures, all of which were classified as Type A according to Essex Lopresti Calcaneal Fracture Classification. Two of the patients with renal failure were in a routine dialysis program, as well as vascular compromise and osteomyelitis in all of the patients...
July 16, 2016: World Journal of Clinical Cases
Latricia L Allen, Garrett Kalmar, Vickie R Driver
We report a case of calcaneal osteomyelitis that was surgically resected from a patient with diabetes and peripheral vascular disease. A 91-year-old male with history of type 2 diabetes, peripheral vascular disease, balloon angioplasty, and recent (2 months ago) stent of the superficial femoral artery presented to the emergency department with a left heel wound infection probed to bone. The patient reported having been on intravenous Zosyn for several months via an outside infectious disease provider for clinical suspicion of osteomyelitis, but noted no improvement...
June 2016: Techniques in Vascular and Interventional Radiology
Sachin Allahabadi, Kareem B Haroun, Daniel M Musher, Benjamin A Lipsky, Neal R Barshes
BACKGROUND: The aim of this study was to develop consensus statements that may help share or even establish 'best practices' in the surgical aspects of managing diabetic foot osteomyelitis (DFO) that can be applied in appropriate clinical situations pending the publication of more high-quality data. METHODS: We asked 14 panelists with expertise in DFO management to participate. Delphi methodology was used to develop consensus statements. First, a questionnaire elicited practices and beliefs concerning various aspects of the surgical management of DFO...
2016: Diabetic Foot & Ankle
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