Mid- and Hindfoot Amputations in Diabetic Patients
Several surgical options exist to avoid or at least to delay a below-the-knee amputation (BKA). These are the so-called mid- or hindfoot amputations. They are a valuable treatment option in order to maintain the ability to ambulate without major auxiliary means (eg, a prosthesis). Hence, these amputations allow the patients to maintain certain autonomy. The acceptance of these amputations is significantly higher than a BKA, as the body image is less disturbed. The complication rate in hindfoot amputations in diabetic patients is high due to the comorbidities, in particular peripheral arterial disease and polyneuropathy. (S...
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Authors: Martin C. Berli Source Type: research
Shooting Star: A Tribute to Alexej Barg
The last couple of months have been very hard for the Foot and Ankle Surgery Community, which was shocked by the unexpected news of Alexej Barg's passing. Our specialty lost one of its most prominent and brilliant names, with research contributions that have substantially changed our way of thinking, optimized the understanding of multiple pathologies, and improved the care of patients. Foot and Ankle Clinics of North America Editorial, unfortunately, lost its most passionate and excited Associate Editor. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Authors: Cesar de Cesar Netto Tags: Foreword Source Type: research
The Diabetic Foot
FOOT AND ANKLE CLINICS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Authors: Fabian Krause Source Type: research
Copyright
ELSEVIER (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Source Type: research
Contributors
CESAR DE CESAR NETTO, MD, PhD (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Source Type: research
Editorial Advisory Board
J. Kent Ellington, MD, MS, FAAOS (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Source Type: research
Contents
Cesar de Cesar Netto (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Source Type: research
Forthcoming Issues
Managing Challenging Deformities with Arthrodesis of the Foot and Ankle (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - September 1, 2022 Category: Orthopaedics Source Type: research
Limb Salvage in Severe Diabetic Foot Infection
Severe diabetic foot infections (DFI) are both limb threatening and life threatening and associated with negative impact on health-related quality of life. Most severe DFIs require surgical intervention, and the goal of treatment should be preservation of limb function in addition to eradication of infection. Minor amputations are required in approximately 40% and major amputations in approximately 20% of patients. Significant risk factors for lower extremity amputation included male gender, smoking, previous amputation, osteomyelitis, peripheral artery disease, retinopathy, severe infections, gangrene, neuroischemic diabe...
Source: Foot and Ankle Clinics - August 9, 2022 Category: Orthopaedics Authors: Dane K. Wukich, Matthew J. Johnson, Katherine M. Raspovic Source Type: research
Etiology, Epidemiology, and Outcomes of Managing Charcot Arthropathy
This article aims to summarize the cause of Charcot, look at the factors that influence the outcomes, and the financial cost of managing what is a very challenging condition. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 9, 2022 Category: Orthopaedics Authors: Thomas Hester, Venu Kavarthapu Source Type: research
Dear foot and ankle surgeons!
Even though there is extended knowledge on how to prevent diabetes and its complications, how to control blood sugar levels, and how to treat diabetes-related complications in combination with a rising awareness that healthy nutrition is important to avoid diabetes mellitus, the prevalence of diabetes mellitus in our aging population is increasing all over the world. The prevalence of diabetes mellitus ranges from 13.3% in Mexico to 3.2% in Ireland, and in the United States, more than 30 million Americans, representing 12% of the population, has the condition. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 9, 2022 Category: Orthopaedics Authors: Fabian Krause Tags: Preface Source Type: research
Nonoperative Treatment of Charcot Neuro-osteoarthropathy
Conservative treatment of Charcot neuro-osteoarthropathy (CN) aims to retain a stable, plantigrade, and ulcer-free foot, or to prevent progression of an already existing deformity. CN is treated with offloading in a total contact cast as long as CN activity is present. Transition to inactive CN is monitored by the resolution of clinical activity signs and by resolution of bony edema in MRI. Fitting of orthopedic depth insoles, orthopedic shoes, or ankle-foot orthosis should follow immediately after offloading has ended to prevent CN reactivation or ulcer development. (Source: Foot and Ankle Clinics)
Source: Foot and Ankle Clinics - August 9, 2022 Category: Orthopaedics Authors: Felix W.A. Waibel, Thomas B öni Source Type: research
The Interdisciplinary Approach
The appropriate treatment of the common diabetic foot ulcers (DFUs) in diabetic patients demands enormous human, organizational and financial resources that are finite. Interdisciplinary teams of medical and surgical specialists, as well as allied health professionals, can help to reduce the consumption of these resources, optimize treatment, and prevent DFUs. They consist primarily of vascular surgeons, endocrinologists, and orthopedic foot and ankle surgeons and are closely supported when required by infectious diseases specialists, plastic surgeons, wound care specialist nurses, podiatrists, and orthotists. A timely int...
Source: Foot and Ankle Clinics - August 7, 2022 Category: Orthopaedics Authors: Christophe Kurze, Chui Jia Farn, James Siow Source Type: research
Diagnostic Imaging of Diabetic Foot Disorders
Plain, weight-bearing radiography is the preferred first-line imaging. Dependent on the suspected pathology, further imaging is indicated. In a soft tissue infection, an abscess has to be excluded, for example, with ultrasound. Osteomyelitis has a typical triad including osteolysis, periosteal reaction, and bone destruction in radiography, but signs are often delayed. MRI is the gold standard for diagnosis of osteomyelitis with high intensity in T2-weighted and STIR images and intermediate to decreased reticulated hazy intensity in T1-weighted images. In comparison, bone marrow edema is also bright on the T2-weighted image...
Source: Foot and Ankle Clinics - August 6, 2022 Category: Orthopaedics Authors: Keivan Daneshvar, Helen Anwander Source Type: research
Managing Acute Fore- and Midfoot Fractures in Patients with Diabetes
Few is investigated about the management of acute fore- and midfoot injuries in diabetics. With well controlled diabetes, indications and techniques are similar to non-diabetics. With poorly controlled diabetes, medical optimization should be exercised. Stable internal fixation in case of surgical treatment and prolonged offloading independent of the choice of treatment are advised. With manifest Charcot neuroarthropathy, the goal is to achieve a plantigrade, stable foot that is infection- and ulcer-free and ambulant with orthopaedic shoes. If operative treatment is chosen, the concept of superconstructs in combination wit...
Source: Foot and Ankle Clinics - August 6, 2022 Category: Orthopaedics Authors: Choon Chiet Hong, Stefan Rammelt Source Type: research
