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93 full-text articles. Page 4 of 5.

Charcot Foot: New Treatments, Better Outcomes, Thomas Zgonis, T. Roukis, John Stapleton, D. Cromack 2015 Lehigh Valley Health Network

Charcot Foot: New Treatments, Better Outcomes, Thomas Zgonis, T. Roukis, John Stapleton, D. Cromack

John J Stapleton DPM, FACFAS

No abstract provided.


Diabetic Foot Infections: A Team-Oriented Review Of Medical And Surgical Management., Claire M Capobianco, John Stapleton 2015 University of Texas Health Science - San Antonio

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 2015 University of Texas Health Science - San Antonio

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 2015 Lehigh Valley Health Network

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.


Utilizing A Crossover Reverse Sural Artery Flap For Soft Tissue Reconstruction Of The Plantar Forefoot After A Severe Degloving Injury., Thomas Zgonis, Douglas T Cromack, John Stapleton 2015 University of Texas Health Science - San Antonio

Utilizing A Crossover Reverse Sural Artery Flap For Soft Tissue Reconstruction Of The Plantar Forefoot After A Severe Degloving Injury., Thomas Zgonis, Douglas T Cromack, John Stapleton

John J Stapleton DPM, FACFAS

Extensive soft tissue defects involving the weight-bearing areas of the plantar aspect of the foot often require coverage with flaps. The options often include free flaps, free muscle flaps with split-thickness skin grafting, or local flaps. When presented with high-energy-induced soft tissue injuries of the foot, choices become narrow, secondary to the associated zone of injury. Free flaps require a viable recipient vessel suitable for microvascular anastomosis. Split-thickness skin grafts applied to the plantar aspect of the foot are prone to persistent breakdown. Local flaps if available are useful for coverage of plantar soft tissue defects. However, when local flaps …


Stepwise Approach To Midfoot And Hindfoot Elective And Reconstructive Surgery With External Fixation, John Stapleton, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Midfoot And Hindfoot Elective And Reconstructive Surgery With External Fixation, John Stapleton, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


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 2015 University of Texas Health Science - San Antonio

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.


Surgically Induced Charcot Neuroarthropathy Following Partial Forefoot Amputation In Diabetes., T Zgonis, John Stapleton, N Shibuya, T S Roukis 2015 University of Texas Health Science - San Antonio

Surgically Induced Charcot Neuroarthropathy Following Partial Forefoot Amputation In Diabetes., T Zgonis, John Stapleton, N Shibuya, T S Roukis

John J Stapleton DPM, FACFAS

No abstract provided.


Revisional Charcot Foot And Ankle Surgery., John Stapleton, Ronald Belczyk, Thomas Zgonis 2015 Lehigh Valley Health Network

Revisional Charcot Foot And Ankle Surgery., John Stapleton, Ronald Belczyk, Thomas Zgonis

John J Stapleton DPM, FACFAS

Charcot neuroarthropathy is often a devastating diabetic foot complication that poses a great risk for limb loss and can have a significant impact on a patient's quality of life in the presence of multiple existing comorbidities. It is a progressive and debilitating condition characterized by joint dislocation, pathologic fracture(s), and extensive destruction of the foot or ankle architecture secondary to dense peripheral neuropathy. This pathologic process can be idiopathic, secondary to acute trauma or previous surgery, or attributable to repetitive "microinjury." Once the Charcot process has been initiated, continued ambulation results in progressive collapse and deformity. Severe deformities can have …


Surgical Treatment Of Tibial Plafond Fractures., John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

Surgical Treatment Of Tibial Plafond Fractures., John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Intra-articular fractures of the tibial plafond are typically the result of rotational or axial loading forces, and both mechanisms of injuries can result in an associated fibula fracture. Rotational distal tibial plafond fractures are typically of lower energy and are associated with less articular injury and chondral impaction, whereas axial load injuries of the distal tibial plafond are associated with a higher incidence of intra-articular and soft tissue injury. The goal of this article is to review the mechanisms of injury, fracture patterns, and potential complications associated with the most common presentations of tibial plafond fractures.


Pertinent Insights On Plastic Surgery And The Diabetic Foot, Z. Facaros, Crystal Ramanujam, John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

Pertinent Insights On Plastic Surgery And The Diabetic Foot, Z. Facaros, Crystal Ramanujam, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Use Of The Taylor Spatial Frame For Arthrodiastasis Of The Ankle Joint, Thomas Zgonis, John Stapleton, T. Roukis 2015 Lehigh Valley Health Network

Use Of The Taylor Spatial Frame For Arthrodiastasis Of The Ankle Joint, Thomas Zgonis, John Stapleton, T. Roukis

John J Stapleton DPM, FACFAS

No abstract provided.


Lower Extremity Complex Trauma And Complications., John Stapleton 2015 Lehigh Valley Health Network

Lower Extremity Complex Trauma And Complications., John Stapleton

John J Stapleton DPM, FACFAS

No abstract provided.


A Case Report Of A Double Advancement Flap Closure Combined With An Ilizarov Technique For The Chronic Plantar Forefoot Ulceration., Ronald Belczyk, John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

A Case Report Of A Double Advancement Flap Closure Combined With An Ilizarov Technique For The Chronic Plantar Forefoot Ulceration., Ronald Belczyk, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Soft tissue closure of defects on the plantar surface of the foot continues to be a challenge for the reconstructive surgeon secondarily to the limited number of surgical options and often difficulty of replacing durable and similar soft tissue coverage. Primary closure and skin grafting may not be suitable for the weight-bearing surfaces of the plantar forefoot area, and closure may then be obtained by other means of plastic surgery techniques.


Stepwise Approach To Taylor Spatial Frame For The Foot And Ankle, John Stapleton, V. Polyzois, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Taylor Spatial Frame For The Foot And Ankle, John Stapleton, V. Polyzois, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Surgical Treatment Of Calcaneal Fracture Malunions And Posttraumatic Deformities., John Stapleton, Ronald Belczyk, Thomas Zgonis 2015 Lehigh Valley Health Network

Surgical Treatment Of Calcaneal Fracture Malunions And Posttraumatic Deformities., John Stapleton, Ronald Belczyk, Thomas Zgonis

John J Stapleton DPM, FACFAS

The surgical management of calcaneal fractures presents with several obstacles to the treating physician. Many experienced surgeons acknowledge a steep and significant learning curve in the operative management of calcaneal fractures. Nonoperative management of displaced intra-articular calcaneal fractures may result in malunion, thereby affecting the function of the ankle and subtalar joint. Although some calcaneal fractures can be treated conservatively, a majority of them require operative intervention. The goal of this article is to bring some insight into the realm of revisional surgery on residual deformity of the calcaneus after operative intervention and also provide a rationale approach to successfully …


Surgical Reconstruction Of The Diabetic Charcot Foot: Internal, External Or Combined Fixation?, John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

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.


Complications And Revisional Hallux Valgus Surgery., Ronald Belczyk, John Stapleton, Jordan P Grossman, Thomas Zgonis 2015 Lehigh Valley Health Network

Complications And Revisional Hallux Valgus Surgery., Ronald Belczyk, John Stapleton, Jordan P Grossman, Thomas Zgonis

John J Stapleton DPM, FACFAS

Complications with hallux valgus surgery can manifest in a variety of ways, but ultimately preventing them depends on the surgeon's expertise in patient and procedural selection, ability to perform the surgery selected, and knowledge in dealing with postoperative care and complications if present. In this article, the authors discuss common diagnostic and treatment dilemmas when dealing with recurrent hallux valgus, hallux varus, malunion, and avascular necrosis following bunion surgery.


Charcot Foot And Ankle Deformity, T. Zgonis, John Stapleton, T. Roukis 2015 Lehigh Valley Health Network

Charcot Foot And Ankle Deformity, T. Zgonis, John Stapleton, T. Roukis

John J Stapleton DPM, FACFAS

No abstract provided.


Management Of Diabetic Neuropathic Foot And Ankle Malunions And Nonunions., John Stapleton 2015 Lehigh Valley Health Network

Management Of Diabetic Neuropathic Foot And Ankle Malunions And Nonunions., John Stapleton

John J Stapleton DPM, FACFAS

The management of diabetic neuropathic foot and ankle malunions and/or nonunions is often complicated by the presence of broken or loosened hardware, Charcot joints, infection, osteomyelitis, avascular bone necrosis, unstable deformities, bone loss, disuse and pathologic osteopenia, and ulcerations. The author discusses a rational approach to functional limb salvage with various surgical techniques that are aimed at achieving anatomic alignment, long-term osseous stability, and adequate soft tissue coverage. Emphasis is placed on techniques to overcome the inherent challenges that are encountered when surgically managing a diabetic nonunion and/or malunion. Particular attention is directed to the management of deep infection and …


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