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Full-Text Articles in Podiatry
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 …
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.
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. …
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.
Combined Lateral Column Arthrodesis, Medial Plantar Arteryflap, And Circular External Fixation For Charcot Midfoot Collapse With Chronic Plantar Ulceration., Thomas Zgonis, Thomas S Roukis, John Stapleton, Douglas T Cromack
Combined Lateral Column Arthrodesis, Medial Plantar Arteryflap, And Circular External Fixation For Charcot Midfoot Collapse With Chronic Plantar Ulceration., Thomas Zgonis, Thomas S Roukis, John Stapleton, Douglas T Cromack
John J Stapleton DPM, FACFAS
No abstract provided.
Surgical Reconstruction Of The Diabetic Charcot Foot: Internal, External Or Combined Fixation?, John Stapleton, Thomas Zgonis
Surgical Reconstruction Of The Diabetic Charcot Foot: Internal, External Or Combined Fixation?, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Charcot neuroarthropathy of the foot and ankle is a devastating neuropathic complication that can eventually lead to a lower extremity amputation in the presence of an ulceration or infection. Current surgical approaches for the management of the diabetic Charcot foot and ankle deformities are largely based on expert opinions in various fixation methods attempting to avoid major postoperative complications. The goal of this article is to discuss the advantages and disadvantages of various internal, external, or combined fixation methods as they relate to the inherent challenges in the management of the diabetic Charcot foot.
Combined Medial Displacement Calcaneal Osteotomy, Subtalar Joint Arthrodesis, And Ankle Arthrodiastasis For End-Stage Posterior Tibial Tendon Dysfunction., John Stapleton, Ronald Belczyk, Thomas Zgonis, Vasilios D Polyzois
Combined Medial Displacement Calcaneal Osteotomy, Subtalar Joint Arthrodesis, And Ankle Arthrodiastasis For End-Stage Posterior Tibial Tendon Dysfunction., John Stapleton, Ronald Belczyk, Thomas Zgonis, Vasilios D Polyzois
John J Stapleton DPM, FACFAS
Combining an ankle arthrodiastasis with a medial displacement calcaneal osteotomy and a subtalar joint arthrodesis offers surgeons a joint-sparing procedure for young and active patients who have end-stage posterior tibial tendon dysfunction and ankle joint involvement. An isolated subtalar joint arthrodesis or triple arthrodesis combined with an ankle arthrodiastasis is an option that can be used in certain case scenarios. Delaying the need for a joint destructive procedure through an ankle arthrodiastasis, however, may have a great impact in the near future, as advancements are underway to improve the use of ankle endoprosthesis.
Advanced Foot And Ankle Fixation Techniques In Patients With Diabetes., Nicholas J Bevilacqua, John Stapleton
Advanced Foot And Ankle Fixation Techniques In Patients With Diabetes., Nicholas J Bevilacqua, John Stapleton
John J Stapleton DPM, FACFAS
This article presents advanced techniques and current fixation constructs that are advantageous for the management of diabetic foot and ankle trauma and Charcot neuroarthropathy. Both these pathologies are often intimately related, and the fixation constructs that are required often require sound biomechanical concepts coupled with innovative approaches to achieve bone healing and limb salvage.