Open Access. Powered by Scholars. Published by Universities.®
- Keyword
-
- Department of Surgery (61)
- Humans (28)
- Diabetic Foot (16)
- External Fixators (14)
- Surgical Flaps (10)
-
- Arthropathy (9)
- Neurogenic (9)
- Debridement (8)
- Treatment Outcome (8)
- Arthrodesis (7)
- Wound Healing (7)
- Amputation (6)
- Male (6)
- Combined Modality Therapy (5)
- Limb Salvage (5)
- Patient Selection (5)
- Preoperative Care (5)
- Ankle Joint (4)
- Bone (4)
- Calcaneus (4)
- Distraction (4)
- Fractures (4)
- Orthopedic Procedures (4)
- Osteogenesis (4)
- Osteomyelitis (4)
- Patient Care Team (4)
- Postoperative Complications (4)
- Reoperation (4)
- Skin Transplantation (4)
- Soft Tissue Infections (4)
- File Type
Articles 1 - 30 of 62
Full-Text Articles in Medicine and Health Sciences
Tibialis Anterior Tendon Transfer For Posterior Tibial Tendon Insufficiency., Crystal L Ramanujam, John J. Stapleton Dpm, Facfas, Thomas Zgonis
Tibialis Anterior Tendon Transfer For Posterior Tibial Tendon Insufficiency., Crystal L Ramanujam, John J. Stapleton Dpm, Facfas, Thomas Zgonis
John J Stapleton DPM, FACFAS
The Cobb procedure is useful for addressing stage 2 posterior tibial tendon dysfunction and is often accompanied by a medial displacement calcaneal osteotomy and/or lateral column lengthening. The Cobb procedure can also be combined with selected medial column arthrodesis and realignment osteotomies along with equinus correction when indicated.
Local And Distant Pedicle Flaps For Soft Tissue Reconstruction Of The Diabetic Foot: A Stepwise Approach With The Use Of External Fixation, T. Zgonis, John Stapleton, I. Papakostas
Local And Distant Pedicle Flaps For Soft Tissue Reconstruction Of The Diabetic Foot: A Stepwise Approach With The Use Of External Fixation, T. Zgonis, John Stapleton, I. Papakostas
John J Stapleton DPM, FACFAS
No abstract provided.
Stepwise Approach To Static Circular External Fixation, John Stapleton, V. Polyzois, T. Zgonis
Stepwise Approach To Static Circular External Fixation, John Stapleton, V. Polyzois, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Use Of Circular External Fixation For Combined Subtalar Joint Fusion And Ankle Distraction., Thomas Zgonis, John Stapleton, Thomas S Roukis
Use Of Circular External Fixation For Combined Subtalar Joint Fusion And Ankle Distraction., Thomas Zgonis, John Stapleton, Thomas S Roukis
John J Stapleton DPM, FACFAS
The authors discuss a novel technique not previously published that incorporates a subtalar joint arthrodesis with an ankle joint arthrodiastasis as an alternative to a tibiotalocalcaneal arthrodesis. Young and active patients who experience refractory pain and stiffness to the rearfoot and ankle secondary to combined severe subtalar and ankle arthrosis are suitable candidates for this surgical procedure. This new approach is based on sound principles in the treatment of severe arthrosis affecting the ankle and subtalar joint. The authors are currently prospectively reviewing their surgical experience with this procedure and believe that it provides an alternative option for the patient, …
Surgical Management Of Diabetic Foot And Ankle Infections., Claire M Capobianco, John Stapleton, Thomas Zgonis
Surgical Management Of Diabetic Foot And Ankle Infections., Claire M Capobianco, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Delayed treatment of any diabetic foot infection can lead to a limb- or life-threatening scenario. Urgent and/or emergent surgery may be necessary in the early diagnosis of a severe diabetic foot infection that is followed by staged reconstructive procedures. This article provides the reader with a thorough understanding of the surgical management of severe diabetic foot infections and describes and guides treatment based on a rational schematic approach that identifies the anatomic location of the diabetic foot infection.
Innovative Techniques In Preventing And Salvaging Neurovascular Pedicle Flaps In Reconstructive Foot And Ankle Surgery., Thomas Zgonis, John Stapleton
Innovative Techniques In Preventing And Salvaging Neurovascular Pedicle Flaps In Reconstructive Foot And Ankle Surgery., Thomas Zgonis, John Stapleton
John J Stapleton DPM, FACFAS
Pedicle flaps to cover soft tissue defects of the foot, ankle, and lower extremity are invaluable. However, venous congestion and flap necrosis, a common complication, poses greater morbidity to the patient as few remaining options for attempted limb salvage remain. The authors discuss how to prevent flap failure by allowing close observation and strict offloading of the pedicle flap through current external fixation designs. This article also discusses the role of medicinal leeches in reestablishing blood flow through the pedicle flap to prevent tissue necrosis. In addition, the use of hydrosurgery as an innovative technique offers the surgeon another option …
Stepwise Approach To Ankle/Pilon Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis
Stepwise Approach To Ankle/Pilon Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
A Case Report Of A Simultaneous Local Osteochondral Autografting And Ankle Arthrodiastasis For The Treatment Of A Talar Dome Defect., Ronald Belczyk, John Stapleton, Thomas Zgonis, Vasilios D Polyzois
A Case Report Of A Simultaneous Local Osteochondral Autografting And Ankle Arthrodiastasis For The Treatment Of A Talar Dome Defect., Ronald Belczyk, John Stapleton, Thomas Zgonis, Vasilios D Polyzois
John J Stapleton DPM, FACFAS
Talar osteochondral defects (OCDs) are a challenge for treating physicians because they frequently are missed or diagnosed incorrectly, often resulting in severe degenerative arthritis of the ankle joint. Surgical intervention becomes a viable option in the presence of larger OCDs associated with loose bodies or osteochondral lesions that have failed conservative treatment. The successful use of autologous osteochondral autograft in the knee has promoted the applicability in the ankle. This report describes a unique technique for the treatment of large talar osteochondral lesions using a local osteochondral autograft combined with an ankle arthrodiastasis.
Negative-Pressure Wound Therapy In The Management Of Diabetic Charcot Foot And Ankle Wounds., Crystal L Ramanujam, John Stapleton, Thomas Zgonis
Negative-Pressure Wound Therapy In The Management Of Diabetic Charcot Foot And Ankle Wounds., Crystal L Ramanujam, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
As the prevalence of diabetes mellitus continues to rise, innovative medical and surgical treatment options have increased dramatically to address diabetic-related foot and ankle complications. Among the most challenging clinical case scenarios is Charcot neuroarthropathy associated with soft tissue loss and/or osteomyelitis. In this review article, the authors present a review of the most common utilizations of negative-pressure wound therapy as an adjunctive therapy or combined with plastic surgery as it relates to the surgical management of diabetic Charcot foot and ankle wounds.
The Diabetic Foot, C. Ramanujam, John Stapleton, T. Zgonis
The Diabetic Foot, C. Ramanujam, John Stapleton, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Split-Thickness Skin Grafts For Closure Of Diabetic Foot And Ankle Wounds: A Retrospective Review Of 83 Patients., Crystal L Ramanujam, John Stapleton, Krista L Kilpadi, Roberto H Rodriguez, Luke C Jeffries, Thomas Zgonis
Split-Thickness Skin Grafts For Closure Of Diabetic Foot And Ankle Wounds: A Retrospective Review Of 83 Patients., Crystal L Ramanujam, John Stapleton, Krista L Kilpadi, Roberto H Rodriguez, Luke C Jeffries, Thomas Zgonis
John J Stapleton DPM, FACFAS
The aim of this study was to determine if split-thickness skin grafts could be successfully used for closure of foot and ankle wounds in diabetic patients. The authors retrospectively reviewed the charts of 100 consecutive patients who underwent a soft tissue surgical reconstruction with split-thickness skin grafts to their foot and/or ankle in our institution from 2005 to 2008. After application of inclusion criteria, 83 eligible charts remained. Of the 83 patients, 54 (65%) healed uneventfully, 23 (28%) required regrafting, and 6 (7%) had a complication resolved with conservative management. All patients had a successful surgical outcome, defined as having …
Revisional And Reconstructive Surgery Of The Diabetic Foot And Ankle, T. Zgonis, John Stapleton, V. Polyzois, E. Sella
Revisional And Reconstructive Surgery Of The Diabetic Foot And Ankle, T. Zgonis, John Stapleton, V. Polyzois, E. Sella
John J Stapleton DPM, FACFAS
No abstract provided.
Muscle Flaps For Soft Tissue Coverage Of The Diabetic Foot, John Stapleton, T. Zgonis, G. Jolly, T. Badekas
Muscle Flaps For Soft Tissue Coverage Of The Diabetic Foot, John Stapleton, T. Zgonis, G. Jolly, T. Badekas
John J Stapleton DPM, FACFAS
No abstract provided.
Internal And External Fixation Approaches To The Surgical Management Of Calcaneal Fractures., John Stapleton, Gennady Kolodenker, Thomas Zgonis
Internal And External Fixation Approaches To The Surgical Management Of Calcaneal Fractures., John Stapleton, Gennady Kolodenker, Thomas Zgonis
John J Stapleton DPM, FACFAS
Calcaneal fractures are one of the most difficult fractures to surgically manage and often require a steep learning curve to achieve consistent results. They usually occur in young individuals with labor intensive occupations and are associated with major complications. Conservative treatment of intraarticular calcaneal fractures with displacement often results in significant deformity, bone loss, and posttraumatic arthrosis. Optimally, an open approach is required in most cases to achieve anatomic reduction and successful long-term outcomes.
Current Insights In Treating Diabetic Foot And Ankle Trauma, John Stapleton, Thomas Zgonis
Current Insights In Treating Diabetic Foot And Ankle Trauma, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Surgical Management Of Diabetic Charcot Foot And Ankle Deformities, John Stapleton, Zacharia Facaros, Vasilios Polyzois, Thomas Zgonis
Surgical Management Of Diabetic Charcot Foot And Ankle Deformities, John Stapleton, Zacharia Facaros, Vasilios Polyzois, Thomas Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Combined Circular External Fixation And Open Reduction Internal Fixation With Pro-Syndesmotic Screws For Repair Of A Diabetic Ankle Fracture., Zacharia Facaros, Crystal L Ramanujam, John Stapleton
Combined Circular External Fixation And Open Reduction Internal Fixation With Pro-Syndesmotic Screws For Repair Of A Diabetic Ankle Fracture., Zacharia Facaros, Crystal L Ramanujam, John Stapleton
John J Stapleton DPM, FACFAS
The surgical management of ankle fractures among the diabetic population is associated with higher complication rates compared to the general population. Efforts toward development of better methods in prevention and treatment are continuously evolving for these injuries. The presence of peripheral neuropathy and the possible development of Charcot neuroarthropathy in this high risk patient population have stimulated much surgical interest to create more stable osseous constructs when open reduction of an ankle fracture/dislocation is required. The utilization of multiple syndesmotic screws (pro-syndesmotic screws) to further stabilize the ankle mortise has been reported by many foot and ankle surgeons. In addition, …
Soft Tissue Reconstruction Pyramid In The Diabetic Foot., Claire M Capobianco, John Stapleton, Thomas Zgonis
Soft Tissue Reconstruction Pyramid In The Diabetic Foot., Claire M Capobianco, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Foot complications and ulceration are well-known sequelae to uncontrolled diabetes. Patients with chronic foot ulcers or wounds resulting from surgical debridement of deep-space infections are at continued risk for development of osteomyelitis and potential amputation. Moreover, these wounds often necessitate multiple outpatient clinic visits, daily dressing care, and prolonged periods of non-weight bearing, all of which have been shown to adversely affect the patient's quality of life. After a prudent period of wound-healing response, the authors believe that early and aggressive soft tissue reconstruction is in the patient's best interest and is crucial for resolution of the chronic nonhealing wound. …
Advanced Plastic Surgery Techniques For Soft Tissue Coverage Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Thomas S Roukis
Advanced Plastic Surgery Techniques For Soft Tissue Coverage Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Thomas S Roukis
John J Stapleton DPM, FACFAS
Obtaining stable, durable, and functional wound closure of a diabetic foot wound or open pedal amputation through plastic surgical techniques is essential to limit the potential for repeated ulceration, infection, and "supra-pedal" amputation. Myriad conservative and surgical techniques can be used to obtain wound closure. The authors discuss their approach and present operative pearls for their most commonly employed plastic surgical techniques to provide adequate soft tissue coverage of diabetic foot wounds. Emphasis is placed on the techniques necessary to perform these procedures and the surgical thought process involved in closing diabetic foot wounds.
Stepwise Approach To Forefoot Trauma And External Fixation, C. Capobianco, John Stapleton, T. Zgonis
Stepwise Approach To Forefoot Trauma And External Fixation, C. Capobianco, John Stapleton, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Stepwise Approach To Midfoot/ Hindfoot Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis
Stepwise Approach To Midfoot/ Hindfoot Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Stepwise Approach To Adult And Pediatric Foot And Ankle Malunions/Nonunions And External Fixation, A. Cherkashin, M. Samchukov, J. Birch, John Stapleton, T. Zgonis
Stepwise Approach To Adult And Pediatric Foot And Ankle Malunions/Nonunions And External Fixation, A. Cherkashin, M. Samchukov, J. Birch, John Stapleton, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Transmetatarsal Amputations., George F Wallace, John Stapleton
Transmetatarsal Amputations., George F Wallace, John Stapleton
John J Stapleton DPM, FACFAS
Transmetatarsal amputation is an excellent procedure in the face of nonhealing ulceration, infection, trauma, peripheral vascular disease, and tumors. This article discusses transmetatarsal amputations, the decision-making process, timing of surgery, operative techniques, postoperative management, and salvage of the failed transmetatarsal amputation.
Current Concepts With External Fixation And The Charcot Foot, Crystal Ramanujam, John Stapleton, Thomas Zgonis
Current Concepts With External Fixation And The Charcot Foot, Crystal Ramanujam, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.
Charcot Foot: New Treatments, Better Outcomes, Thomas Zgonis, T. Roukis, John Stapleton, D. Cromack
Charcot Foot: New Treatments, Better Outcomes, Thomas Zgonis, T. Roukis, John Stapleton, D. Cromack
John J Stapleton DPM, FACFAS
No abstract provided.
Plastic Surgery Reconstruction Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Roberto H Rodriguez, Valerie A Girard-Powell, Douglas T Cromack
Plastic Surgery Reconstruction Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Roberto H Rodriguez, Valerie A Girard-Powell, Douglas T Cromack
John J Stapleton DPM, FACFAS
Soft tissue reconstruction of the diabetic foot is a challenge for the perioperative team. Primary closure may not be an option and secondary healing may not be reliable. Therefore, surgery is vital and should be coordinated among a well-functioning multidisciplinary team that specializes in caring for patients with diabetes mellitus. Team members must have expertise in reconstructive surgery to ensure adequate wound healing. This article emphasizes the appropriate timing and staging of surgery, discusses the most common plastic surgery techniques, and underscores the importance of a team approach in the management of diabetic foot wounds.
Surgical Treatment Of Charcot Neuropathy., Thomas Zgonis, John Stapleton, Luke C Jeffries, Valerie A Girard-Powell, Lynanne J Foster
Surgical Treatment Of Charcot Neuropathy., Thomas Zgonis, John Stapleton, Luke C Jeffries, Valerie A Girard-Powell, Lynanne J Foster
John J Stapleton DPM, FACFAS
Charcot neuroarthropathy, a chronic progressive destruction of joint integrity, is believed to result from a disturbance in pain and proprioceptive sensation. It is most commonly treated in patients with uncontrolled diabetes mellitus and dense peripheral neuropathy. Prevention, early diagnosis, and early treatment are key to a patient's successful outcome. Educating the patient is paramount to avoid further complications and subsequent amputations. This article describes the pathophysiology, staging, surgical treatment, and natural course of Charcot neuroarthropathy.
Diabetic Foot Infections: A Team-Oriented Review Of Medical And Surgical Management., Claire M Capobianco, John Stapleton
Diabetic Foot Infections: A Team-Oriented Review Of Medical And Surgical Management., Claire M Capobianco, John Stapleton
John J Stapleton DPM, FACFAS
As the domestic and international incidence of diabetes and metabolic syndrome continues to rise, health care providers need to continue improving management of the long-term complications of the disease. Emergency department visits and hospital admissions for diabetic foot infections are increasingly commonplace, and a like-minded multidisciplinary team approach is needed to optimize patient care. Early recognition of severe infections, medical stabilization, appropriate antibiotic selection, early surgical intervention, and strategic plans for delayed reconstruction are crucial components of managing diabetic foot infections. The authors review initial medical and surgical management and staged surgical reconstruction of diabetic foot infections in the inpatient …
Diabetic Lisfranc Fracture-Dislocations And Charcot Neuroarthropathy., Bradley A Levitt, John Stapleton, Thomas Zgonis
Diabetic Lisfranc Fracture-Dislocations And Charcot Neuroarthropathy., Bradley A Levitt, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
The goal with Lisfranc fracture-dislocations is to regain joint congruity and reestablish midfoot stability to avoid debilitating posttraumatic arthrosis and chronic pain in the sensate patient. In the diabetic population, dense peripheral neuropathy and/or vascular disease are equally important and may alter the surgical approach to traumatic tarsometatarsal injuries. The initial diagnosis in the diabetic population may be delayed due to subtle radiographic findings and/or patient unawareness of trauma in the insensate foot. Failure to initiate treatment in the early stages of acute diabetic neuropathic Lisfranc injuries can predispose the patient to midfoot instability, potential ulceration, infection, and Charcot neuroarthropathy.
Surgical Treatment Of Intra-Articular Calcaneal Fractures., John Stapleton, Thomas Zgonis
Surgical Treatment Of Intra-Articular Calcaneal Fractures., John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Most intra-articular calcaneal fractures are a result of high-energy trauma. The operative management of calcaneal fractures has been based on achieving anatomic reduction and minimizing complications of the compromised soft tissue envelope. The traditional extensile lateral approach offers advantages of achieving adequate fracture reduction with the risk of wound-healing complications and infection. Limited open reduction and internal fixation techniques with or without using external fixation focuses on achieving fracture reduction with less risk of wound complications but higher risk of malunion. This article discusses key points of operative management for various intra-articular calcaneal fracture patterns and clinical presentations.