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https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#1
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28327419/concomitant-unilateral-post-traumatic-leg-and-foot-compartment-syndrome-in-a-5-years-old-child-case-report
#2
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28323802/outcomes-after-severe-distal-tibia-ankle-and-or-foot-trauma-comparison-of-limb-salvage-versus-transtibial-amputation-outlet
#3
Michael J Bosse, David Teague, Lisa Reider, Joshua L Gary, Saam Morshed, Rachel B Seymour, James Toledano, Lisa K Cannada, Barbara Steverson, Daniel O Scharfstein, Jason Luly, Ellen J MacKenzie
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#4
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#5
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28302263/lower-limb-amputation-in-germany
#6
Knut Kröger, Christian Berg, Frans Santosa, Nasser Malyar, Holger Reinecke
BACKGROUND: Declining amputation rates have been reported in multiple countries in recent years. It is not yet known whether amputation rates have declined in Germany as well. METHODS: On the basis of DRG (diagnosis-related group) data, we received a list from the German Federal Statistical Office of all major and minor amputations documented in German hospitals from 2005 to 2014. Changes over this period were studied with linear regression. RESULTS: The absolute number of amputations per year in Germany rose slightly from 55 689 in 2005 to 57 637 (+3...
February 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28295608/incidence-and-anatomical-variations-of-accessory-navicular-bone-in-patients-with-foot-pain-a-retrospective-radiographic-analysis
#7
Heba Kalbouneh, Omar Alajoulin, Mohammad Alsalem, Noor Humoud, Jamil Shawaqfeh, Mohammad Alkhoujah, Hana Abu-Hassan, Waleed Mahafza, Darwish Badran
INTRODUCTION: The accessory navicular (AN) is an accessory ossicle anatomically located on the medial side of the foot, proximal to the navicular and continuous with the tibialis posterior tendon. It is occasionally a source of pain and local tenderness. Knowledge of the AN and its morphological variations can help identify the source of a patient's symptoms and prevent misinterpreting them as fractures. MATERIALS AND METHODS: Foot radiographs from 1240 patients who presented in two centers with chronic foot pain, or persistent pain developed after trauma, were retrospectively reviewed to determine the incidence and variations of the AN in relation to gender...
March 13, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28255387/reverse-sural-flap-for-ankle-and-heel-soft-tissues-reconstruction
#8
R N Ciofu, D G Zamfirescu, S A Popescu, I Lascar
Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28250702/an-evaluation-of-selected-indications-and-appropriateness-of-ampicillin-sulbactam-an-unrestricted-antimicrobial-at-a-single-center
#9
Dorothy McCoy, Rani Sebti, Arpi G Kuyumjian
BACKGROUND: With antimicrobial resistance on the rise and few new agents in development, it is important to exercise prudent judgment when utilizing antimicrobials. The Antimicrobial Stewardship Program (ASP) is responsible for facilitating the appropriate use of antimicrobials at the institution. Restricted antimicrobials and select additional antimicrobials are monitored by the ASP team to determine if the indications chosen by the ordering prescribers correspond to and are appropriate for the patients' infections...
March 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28222391/a-clinically-applicable-non-invasive-method-to-quantitatively-assess-the-visco-hyperelastic-properties-of-human-heel-pad-implications-for-assessing-the-risk-of-mechanical-trauma
#10
Sara Behforootan, Panagiotis E Chatzistergos, Nachiappan Chockalingam, Roozbeh Naemi
INTRODUCTION: Pathological conditions such as diabetic foot and plantar heel pain are associated with changes in the mechanical properties of plantar soft tissue. However, the causes and implications of these changes are not yet fully understood. This is mainly because accurate assessment of the mechanical properties of plantar soft tissue in the clinic remains extremely challenging. PURPOSE: To develop a clinically viable non-invasive method of assessing the mechanical properties of the heel pad...
February 9, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#11
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28198793/proximity-and-risks-of-the-anterior-neurovascular-and-tendinous-anatomy-of-the-distal-leg-relative-to-anteriorly-applied-distal-locking-screws-for-tibia-nailing-a-plea-for-open-insertion
#12
Phillip M Mitchell, Cory A Collinge, Eric Barcak, Edward Perez, Kostas Triantafillou
PURPOSE: To determine the proximity and potential risks to distal leg anatomy from anterior to posteriorly (A-P) applied distal tibia locking screws for tibial nailing. DESIGN: Retrospective. SETTING: ACS level I trauma center. PATIENTS/PARTICIPANTS: Twenty consecutive adult patients undergoing computed tomograms with intravenous contrast (CTAs) on uninjured legs. MAIN OUTCOME MEASUREMENTS: Simulated 5 mm distal interlocking screws placed in the A-P axis of an ideally placed tibial nail at 10 mm increments from the tibial plafond (10 to 40mm) were studied in relation to the distal leg's anterior anatomy...
February 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28196544/diagnostic-error-in-the-emergency-department-follow-up-of-patients-with-minor-trauma-in-the-outpatient-clinic
#13
Pieter-Jan Moonen, Luc Mercelina, Willem Boer, Tom Fret
BACKGROUND: The Emergency Department (ED) is prone to diagnostic error. Most frequent diagnostic errors involved "minor" trauma. Our goal was to determine how frequently a missed diagnosis was detected during follow up and to determine the frequency and causes of primary missed diagnosis and diagnostic error. METHODS: A retrospective single centre study review, during 6 months including all patients presenting to the outpatient clinic after ED admission with a minor trauma...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28194322/sural-artery-perforator-flap-with-posterior-tibial-neurovascular-decompression-for-recurrent-foot-ulcer-in-leprosy-patients
#14
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28167068/current-controversies-in-foot-and-ankle-trauma
#15
EDITORIAL
Michael P Swords
No abstract text is available yet for this article.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167063/complex-foot-injury-early-and-definite-management
#16
REVIEW
Tim Schepers, Stefan Rammelt
Complex foot injuries occur infrequently, but are life-changing events. They often present with other injuries as the result of a high-energy trauma. After initial stabilization, early assessment should be regarding salvagability. All treatment strategies are intensive. The initial treatment includes prevention of progression ischemia/necrosis, prevention of infection, and considering salvage or amputation. Definitive treatment for salvage includes anatomic reconstruction with stable internal fixation and early soft tissue coverage followed by aggressive rehabilitation...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167057/gastrocnemius-or-achilles-lengthening-at-time-of-trauma-fixation
#17
REVIEW
Stephen K Benirschke, Patricia Ann Kramer
Gastrocnemius equinus is a frequent comorbidity with traumatic injuries of the foot and ankle. Gastrocnemius lengthening at the time of definitive treatment facilitates obtaining and maintaining an anatomic reduction of the injury. The lengthening procedure is accomplished in 5 steps and results in fewer long-term, problematic sequelae.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28152328/a-comparison-of-axial-circumference-between-superficial-circumflex-iliac-artery-perforator-flap-and-other-workhorse-flaps-in-dorsal-foot-reconstruction
#18
Yujin Myung, Sangjun Yim, Baek-Kyu Kim
BACKGROUND: Management and reconstruction of dorsal foot defects present various difficulties and challenges. The main purpose of this article is to discuss experiences of using superficial circumflex iliac perforator (SCIP) flap in various defects of the dorsal foot region. METHODS: From August 2012 to February 2015, a total of 13 patients - nine males and four females - received a reconstruction operation for dorsal foot defects using SCIP flaps (the SCIP group)...
February 2, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28149741/arthroscopic-release-of-lateral-half-of-the-talocalcaneonavicular-joint
#19
Tun Hing Lui
Arthrofibrosis of the talocalcaneonavicular joint can follow trauma or surgery of the joint. Arthroscopic release of the lateral half of the talocalcaneonavicular joint is indicated if the painful restriction of hindfoot inversion together with tenderness of the lateral side of the joint that is not controlled with conservative treatment. This procedure is contraindicated in other causes of painful stiffness including post-traumatic arthritis, osteonecrosis, and malunion. This technique includes arthroscopic release of the lateral side of the anterior subtalar joint and the talonavicular joint...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28126375/reconstruction-of-heel-soft-tissue-defects-using-medial-plantar-artery-island-pedicle-flap-clinical-experience-and-outcomes-analysis
#20
Jia-Xiang Gu, An-Shi Huan, Nai-Chen Zhang, Hong-Jun Liu, Shi-Cong Xia, Subhash Regmi, Lin Yang
We report our clinical experience with 11 cases of heel soft tissue defects treated with a medial plantar artery island pedicle flap. We also evaluated the functional outcomes of reconstruction. We enrolled 11 patients (10 [90.9%] males and 1 [9.1%] female), who received a medial plantar artery island pedicle flap for heel soft tissue defects from August 2010 to July 2014. The cause of the defects included trauma (post-traumatic heel skin necrosis) in 2 (18.2%) patients, infection (calcaneal osteomyelitis with overlying soft tissue infection) in 2 (18...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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