Limb Salvage in Charcot Foot and Ankle Osteomyelitis: Combined Use Single Stage/Double Stage of Arthrodesis and External Fixation
Background: Charcot neuroarthropathy of the foot/ankle is a devastating complication of diabetes. Along with neuroarthropathy, osteomyelitis can occur which can result in amputation. This prospective study evaluated a limb salvage procedure as an alternative to amputation through surgical treatment...
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| Veröffentlicht in: | Foot & ankle international 2009-11, Vol.30 (11), p.1065-1070 |
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| creator | Paola, Luca Dalla Ceccacci, Tanja Ninkovic, Sasa Sorgentone, Sara Marinescu, Maria Grazia |
| description | Background: Charcot neuroarthropathy of the foot/ankle is a devastating complication of diabetes. Along with neuroarthropathy, osteomyelitis can occur which can result in amputation. This prospective study evaluated a limb salvage procedure as an alternative to amputation through surgical treatment of osteomyelitis of the midfoot or the ankle and stabilization with external fixation. Materials and Methods: Forty-five patients with Charcot arthropathy and osteomyelitis underwent debridement and attempted fusion with an external fixator. Chart and radiograph review was performed to assess the success of the fusion and eradication of infection. Results: Out of 45 patients, 39 patients healed using emergent surgery to drain an acute manifestation of the infection while maintaining the fixation for an average of 25.7 weeks. Two patients were treated with intramedullary nail in a subsequent surgical procedure. In four patients, the infection could not be controlled, therefore a major amputation was carried out. Conclusion: For select patients, external fixation proved to be a reasonable alternative to below-knee amputation.
Level of Evidence: IV, Case Series |
| doi_str_mv | 10.3113/FAI.2009.1065 |
| format | Article |
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Level of Evidence: IV, Case Series</description><identifier>ISSN: 1071-1007</identifier><identifier>EISSN: 1944-7876</identifier><identifier>DOI: 10.3113/FAI.2009.1065</identifier><identifier>PMID: 19912716</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Amputation ; Ankle Joint - surgery ; Arthrodesis - methods ; Arthropathy, Neurogenic - complications ; Arthropathy, Neurogenic - surgery ; Debridement ; Diabetic Foot - complications ; External Fixators ; Female ; Humans ; Limb Salvage - methods ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Osteomyelitis - complications ; Osteomyelitis - surgery ; Treatment Failure</subject><ispartof>Foot & ankle international, 2009-11, Vol.30 (11), p.1065-1070</ispartof><rights>2009 American Orthopaedic Foot & Ankle Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-ea59fc93e0c5dd52bab217046e961c426e8f8cebefcc2e9c8add404c60b202b53</citedby><cites>FETCH-LOGICAL-c359t-ea59fc93e0c5dd52bab217046e961c426e8f8cebefcc2e9c8add404c60b202b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.3113/FAI.2009.1065$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.3113/FAI.2009.1065$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19912716$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paola, Luca Dalla</creatorcontrib><creatorcontrib>Ceccacci, Tanja</creatorcontrib><creatorcontrib>Ninkovic, Sasa</creatorcontrib><creatorcontrib>Sorgentone, Sara</creatorcontrib><creatorcontrib>Marinescu, Maria Grazia</creatorcontrib><title>Limb Salvage in Charcot Foot and Ankle Osteomyelitis: Combined Use Single Stage/Double Stage of Arthrodesis and External Fixation</title><title>Foot & ankle international</title><addtitle>Foot Ankle Int</addtitle><description>Background: Charcot neuroarthropathy of the foot/ankle is a devastating complication of diabetes. Along with neuroarthropathy, osteomyelitis can occur which can result in amputation. This prospective study evaluated a limb salvage procedure as an alternative to amputation through surgical treatment of osteomyelitis of the midfoot or the ankle and stabilization with external fixation. Materials and Methods: Forty-five patients with Charcot arthropathy and osteomyelitis underwent debridement and attempted fusion with an external fixator. Chart and radiograph review was performed to assess the success of the fusion and eradication of infection. Results: Out of 45 patients, 39 patients healed using emergent surgery to drain an acute manifestation of the infection while maintaining the fixation for an average of 25.7 weeks. Two patients were treated with intramedullary nail in a subsequent surgical procedure. In four patients, the infection could not be controlled, therefore a major amputation was carried out. Conclusion: For select patients, external fixation proved to be a reasonable alternative to below-knee amputation.
Level of Evidence: IV, Case Series</description><subject>Aged</subject><subject>Amputation</subject><subject>Ankle Joint - surgery</subject><subject>Arthrodesis - methods</subject><subject>Arthropathy, Neurogenic - complications</subject><subject>Arthropathy, Neurogenic - surgery</subject><subject>Debridement</subject><subject>Diabetic Foot - complications</subject><subject>External Fixators</subject><subject>Female</subject><subject>Humans</subject><subject>Limb Salvage - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Negative-Pressure Wound Therapy</subject><subject>Osteomyelitis - complications</subject><subject>Osteomyelitis - surgery</subject><subject>Treatment Failure</subject><issn>1071-1007</issn><issn>1944-7876</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQQC0Eoh9w5Ip8Q0LK1hMndsxttXSh0ko9LD1btjNpXZK42A5qj_zzJuwiTojLeCw9vcM8Qt4BW3EAfrFdX61KxtQKmKhfkFNQVVXIRoqX884kFMCYPCFnKd0zBpKDek1OQCkoJYhT8mvnB0v3pv9pbpH6kW7uTHQh022Yhxlbuh6_90ivU8YwPGHvs0-f6CYM1o_Y0puEdO_H2xnZ51lx8TlM9s-Hho6uY76LocXk02_d5WPGOJqebv2jyT6Mb8irzvQJ3x7fc3Kzvfy2-Vrsrr9cbda7wvFa5QJNrTqnODJXt21dWmNLkKwSqAS4qhTYdI1Di51zJSrXmLatWOUEsyUrbc3PyYeD9yGGHxOmrAefHPa9GTFMSUsJjahVrf5P8gq4EnxxFgfSxZBSxE4_RD-Y-KSB6SWPnvPoJY9e8sz8-6N5sgO2f-ljjxn4eADSfD59H6blVOkftmf9RZiJ</recordid><startdate>200911</startdate><enddate>200911</enddate><creator>Paola, Luca Dalla</creator><creator>Ceccacci, Tanja</creator><creator>Ninkovic, Sasa</creator><creator>Sorgentone, Sara</creator><creator>Marinescu, Maria Grazia</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200911</creationdate><title>Limb Salvage in Charcot Foot and Ankle Osteomyelitis: Combined Use Single Stage/Double Stage of Arthrodesis and External Fixation</title><author>Paola, Luca Dalla ; Ceccacci, Tanja ; Ninkovic, Sasa ; Sorgentone, Sara ; Marinescu, Maria Grazia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-ea59fc93e0c5dd52bab217046e961c426e8f8cebefcc2e9c8add404c60b202b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Amputation</topic><topic>Ankle Joint - surgery</topic><topic>Arthrodesis - methods</topic><topic>Arthropathy, Neurogenic - complications</topic><topic>Arthropathy, Neurogenic - surgery</topic><topic>Debridement</topic><topic>Diabetic Foot - complications</topic><topic>External Fixators</topic><topic>Female</topic><topic>Humans</topic><topic>Limb Salvage - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Negative-Pressure Wound Therapy</topic><topic>Osteomyelitis - complications</topic><topic>Osteomyelitis - surgery</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paola, Luca Dalla</creatorcontrib><creatorcontrib>Ceccacci, Tanja</creatorcontrib><creatorcontrib>Ninkovic, Sasa</creatorcontrib><creatorcontrib>Sorgentone, Sara</creatorcontrib><creatorcontrib>Marinescu, Maria Grazia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Foot & ankle international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paola, Luca Dalla</au><au>Ceccacci, Tanja</au><au>Ninkovic, Sasa</au><au>Sorgentone, Sara</au><au>Marinescu, Maria Grazia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limb Salvage in Charcot Foot and Ankle Osteomyelitis: Combined Use Single Stage/Double Stage of Arthrodesis and External Fixation</atitle><jtitle>Foot & ankle international</jtitle><addtitle>Foot Ankle Int</addtitle><date>2009-11</date><risdate>2009</risdate><volume>30</volume><issue>11</issue><spage>1065</spage><epage>1070</epage><pages>1065-1070</pages><issn>1071-1007</issn><eissn>1944-7876</eissn><abstract>Background: Charcot neuroarthropathy of the foot/ankle is a devastating complication of diabetes. Along with neuroarthropathy, osteomyelitis can occur which can result in amputation. This prospective study evaluated a limb salvage procedure as an alternative to amputation through surgical treatment of osteomyelitis of the midfoot or the ankle and stabilization with external fixation. Materials and Methods: Forty-five patients with Charcot arthropathy and osteomyelitis underwent debridement and attempted fusion with an external fixator. Chart and radiograph review was performed to assess the success of the fusion and eradication of infection. Results: Out of 45 patients, 39 patients healed using emergent surgery to drain an acute manifestation of the infection while maintaining the fixation for an average of 25.7 weeks. Two patients were treated with intramedullary nail in a subsequent surgical procedure. In four patients, the infection could not be controlled, therefore a major amputation was carried out. Conclusion: For select patients, external fixation proved to be a reasonable alternative to below-knee amputation.
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| ispartof | Foot & ankle international, 2009-11, Vol.30 (11), p.1065-1070 |
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| source | MEDLINE; SAGE Complete |
| subjects | Aged Amputation Ankle Joint - surgery Arthrodesis - methods Arthropathy, Neurogenic - complications Arthropathy, Neurogenic - surgery Debridement Diabetic Foot - complications External Fixators Female Humans Limb Salvage - methods Male Middle Aged Negative-Pressure Wound Therapy Osteomyelitis - complications Osteomyelitis - surgery Treatment Failure |
| title | Limb Salvage in Charcot Foot and Ankle Osteomyelitis: Combined Use Single Stage/Double Stage of Arthrodesis and External Fixation |
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