Two-stage reconstruction of infected Charcot foot using internal fixation
| Autor: | Basil Budair, Venu Kavarthapu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Limb salvage Nonunion Arthrodesis medicine Humans Internal fixation Orthopedics and Sports Medicine Stage (cooking) Foot deformity Aged Retrospective Studies business.industry Osteomyelitis Middle Aged Staphylococcal Infections Limb Salvage medicine.disease Diabetic foot Diabetic Foot Surgery Treatment Outcome Female Arthropathy Neurogenic business Foot (unit) Follow-Up Studies |
| Zdroj: | The Bone & Joint Journal. :1611-1618 |
| ISSN: | 2049-4408 2049-4394 |
| Popis: | Aims In our unit, we adopt a two-stage surgical reconstruction approach using internal fixation for the management of infected Charcot foot deformity. We evaluate our experience with this functional limb salvage method. Methods We conducted a retrospective analysis of prospectively collected data of all patients with infected Charcot foot deformity who underwent two-stage reconstruction with internal fixation between July 2011 and November 2019, with a minimum of 12 months’ follow-up. Results We identified 23 feet in 22 patients with a mean age of 56.7 years (33 to 70). The mean postoperative follow-up period was 44.7 months (14 to 99). Limb salvage was achieved in all patients. At one-year follow-up, all ulcers have healed and independent full weightbearing mobilization was achieved in all but one patient. Seven patients developed new mechanical skin breakdown; all went on to heal following further interventions. Fusion of the hindfoot was achieved in 15 of 18 feet (83.3%). Midfoot fusion was achieved in nine of 15 patients (60%) and six had stable and painless fibrous nonunion. Hardware failure occurred in five feet, all with broken dorsomedial locking plate. Six patients required further surgery, two underwent revision surgery for infected nonunion, two for removal of metalwork and exostectomy, and two for dynamization of the hindfoot nail. Conclusion Two-stage reconstruction of the infected and deformed Charcot foot using internal fixation and following the principle of ‘long-segment, rigid and durable internal fixation, with optimal bone opposition and local antibiotic elusion’ is a good form of treatment provided a multidisciplinary care plan is delivered. Cite this article: Bone Joint J 2021;103-B(10):1611–1618. |
| Databáze: | OpenAIRE |
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