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https://www.readbyqxmd.com/read/27898266/methicillin-resistant-staphylococcus-aureus-in-foot-osteomyelitis
#1
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/27888847/mr-imaging-of-the-diabetic-foot
#2
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
#3
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/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#4
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865318/medical-imaging-in-differentiating-the-diabetic-charcot-foot-from-osteomyelitis
#5
REVIEW
Daniel J Short, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) poses a great challenge to diagnose in the early stages and when plain radiographs do not depict any initial signs of osseous fragmentation or dislocation in a setting of a high clinical index of suspicion. Medical imaging, including magnetic resonance imaging, computed tomography, and advanced bone scintigraphy, has its own unique clinical indications when treating the DCN with or without concomitant osteomyelitis. This article reviews different clinical case scenarios for choosing the most accurate medical imaging in differentiating DCN from osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#6
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/27865312/an-overview-of-internal-and-external-fixation-methods-for-the-diabetic-charcot-foot-and-ankle
#7
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865244/tubercular-osteomyelitis-of-calcaneum-bone-a-rare-occurrence
#8
Rajendra Takhar, Motilal Bunkar, Savita Arya, Nitin Mirdha
In spite of the endemic nature of tuberculosis in India, skeletal tuberculosis is relatively infrequent. Involvement of foot bones is uncommon and isolated calcaneum is even rarer. Osteoarticular tuberculosis is a diagnostic enigma, as the characteristic signs and symptoms of this disease may be absent, or mimic other disorders, leading to emergence of complications and therapeutic delay, particularly when the disease affects unusual sites. Here, we are reporting the case of 20-year-old male, who presented with a rare localization of tubercular osteomyelitis involving the calcaneum without adjacent joint involvement to draw attention to this exceptional location in adults, managed with anti-tubercular treatment and gained excellent recovery...
July 2016: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/27843662/neck-of-femur-fracture-in-a-patient-with-a-chronic-osteomyelitis-of-the-ipsilateral-foot
#9
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/27802849/miliary-tuberculosis-and-acquired-immunodeficiency-syndrome-a-cursed-duet
#10
Atif Tatari, Sahana Ramanujam, Suja Mathai, Nigahus Karabulut, Robert L Moser, Sara L Wallach
Tuberculous osteomyelitis is rare and usually involves the vertebrae but is seldom found in the foot. The uncommon site and ability to mimic other disorders clinically and radiographically leads to diagnostic and therapeutic delays. We report a case of a 40-year-old man who initially presented to his podiatrist with intermittent pain and swelling of his right ankle and foot that lasted for a year. He also started to exhibit significant weight loss and unexplained fevers and was subsequently hospitalized for cellulitis of his right foot...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27754891/diabetic-foot-osteomyelitis
#11
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
https://www.readbyqxmd.com/read/27749777/utility-of-pet-ct-with-fluorine-18-fluorodeoxyglucose-labeled-autologous-leukocytes-for-diagnosing-diabetic-foot-osteomyelitis-in-patients-with-charcot-s-neuroarthropathy
#12
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
https://www.readbyqxmd.com/read/27723012/poorly-designed-research-does-not-help-clarify-the-role-of-hyperbaric-oxygen-in-the-treatment-of-chronic-diabetic-foot-ulcers
#13
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
https://www.readbyqxmd.com/read/27722115/clinical-and-functional-outcomes-of-acute-lower-extremity-compartment-syndrome-at-a-major-trauma-hospital
#14
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
https://www.readbyqxmd.com/read/27717819/concomitant-suppurative-parotitis-and-condylar-osteomyelitis
#15
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
https://www.readbyqxmd.com/read/27694302/combination-of-open-subtotal-calcanectomy-and-stabilization-with-external-fixation-as-limb-salvage-procedure-in-hindfoot-infected-diabetic-foot-ulcers
#16
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
https://www.readbyqxmd.com/read/27692828/happy-feet-application-for-the-management-of-diabetic-foot-osteomyelitis
#17
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...
December 2016: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/27673541/a-new-approach-for-reconstruction-of-diabetic-foot-wounds-using-the-angiosome-and-supermicrosurgery-concept
#18
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
https://www.readbyqxmd.com/read/27649405/type-iv-cell-mediated-hypersensitivity-reaction-caused-by-titanium-implant-following-medial-displacement-calcaneal-osteotomy-and-first-metatarsal-cuneiform-arthrodesis
#19
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
https://www.readbyqxmd.com/read/27649403/corynebacterium-striatum-a-concerning-pathogen-of-osteomyelitis-in-the-diabetic-patient
#20
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
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