Clinics in podiatric medicine and surgery
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Clin Podiatr Med Surg · Jan 2009
The use of Ilizarov technique as a definitive percutaneous reduction for ankle fractures in patients who have diabetes mellitus and peripheral vascular disease.
The patient who has a diagnosis of diabetes mellitus, diabetic peripheral neuropathy, peripheral vascular disease and experiences an unstable ankle fracture presents as a difficult case scenario for the treating physician. In addition, patients who have diabetes mellitus, along with the presence of multiple comorbidities, have been shown to have higher complication rates than patients who do not have diabetes mellitus. ⋯ This novel technique decreases the risk for soft tissue complications in the high-risk diabetic patient and serves as a definitive method of fixation without the need for additional surgery. It allows the patient to have early and full weight bearing when indicated in the postoperative period.
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Clin Podiatr Med Surg · Oct 2008
ReviewPercutaneous fixation of forefoot, midfoot, hindfoot, and ankle fracture dislocations.
Open reduction with rigid internal fixation is the basic principle for surgical management in foot and ankle trauma. High-risk patients present a surgical dilemma for the foot and ankle surgeon because the possible complications are magnified in this patient population. ⋯ The significant advantages of percutaneous fixation include minimizing damage to the vascular supply, maintaining and preserving a stable soft tissue envelope, and decreasing the potential risk for infection. This article provides an overview of percutaneous surgical fixation methods and their role in foot and ankle trauma for the high-risk patient.
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Clin Podiatr Med Surg · Oct 2008
ReviewPercutaneous reduction and external fixation for foot and ankle fractures.
Percutaneous reduction with external fixation is an advanced technique for surgical management in foot and ankle trauma. In the high-risk patient, closed or percutaneous reduction followed by external fixation for reduction and stabilization is a unique alternative to achieve anatomic stabilization without increased physical strain to the patient. The significant advantages of this approach include minimizing damage to the vascular supply, maintaining and preserving a stable soft tissue envelope, and allowing for correction to be performed acutely or adjusted gradually over time. This article provides an overview of closed or percutaneous reduction with limited soft tissue dissection and external fixation stabilization techniques, and their role in foot and ankle trauma for the high-risk patient.