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Full-Text Articles in Medicine and Health Sciences
Stepwise Approach To Midfoot And Hindfoot Elective And Reconstructive Surgery With External Fixation, John Stapleton, T. Zgonis
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.
Management Of Foot And Ankle Trauma, Zacharia Facaros, John Stapleton, Vasilios Polyzois, Thomas Zgonis
Management Of Foot And Ankle Trauma, Zacharia Facaros, John Stapleton, Vasilios Polyzois, Thomas 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
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
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.
Salvage Of The First Ray With Concomitant Septic And Gouty Arthritis By Use Of A Bone Block Joint Distraction Arthrodesis And External Fixation., John Stapleton, Roberto H Rodriguez, Luke C Jeffries, Thomas Zgonis
Salvage Of The First Ray With Concomitant Septic And Gouty Arthritis By Use Of A Bone Block Joint Distraction Arthrodesis And External Fixation., John Stapleton, Roberto H Rodriguez, Luke C Jeffries, Thomas Zgonis
John J Stapleton DPM, FACFAS
Gouty arthropathy about the first metatarsal-phalangeal joint with a superimposed deep infection poses a great challenge to the foot and ankle surgeon. The inflammatory nature of gout compromises the soft-tissue envelope and vasculature to the area. Acute gouty arthropathy is usually a contraindication to surgical intervention secondary to wound-healing complications and possible vasospasm leading to tissue necrosis. However, if deep infection is present this must be managed with adequate surgical débridement followed by delayed soft-tissue and osseous reconstruction to prevent amputation. The authors present an exceptional clinical manifestation of gouty arthropathy of the first metatarsal-phalangeal joint concomitant with deep abscess …
A Stepwise Approach To The Surgical Management Of Severe Diabetic Foot Infections., Thomas Zgonis, John Stapleton, Thomas S Roukis
A Stepwise Approach To The Surgical Management Of Severe Diabetic Foot Infections., Thomas Zgonis, John Stapleton, Thomas S Roukis
John J Stapleton DPM, FACFAS
Foot infections are common among diabetic patients with ulceration and are a major cause of hospitalization and lower extremity amputation. Aggressive and emergent surgical intervention is essential in the face of life- or limb-threatening infection to achieve limb salvage and survival. Critical limb ischemia, neuropathy, and an impaired host complicate the treatment of a severe diabetic foot infection. A severe diabetic foot infection carries a 25% risk of major amputation. For this reason, surgery should be coordinated with a well-functioning multidisciplinary team that specializes in diabetic limb preservation. Timing of surgery and strategies employed should be understood and agreed on …
Revisional Charcot Foot And Ankle Surgery., John Stapleton, Ronald Belczyk, Thomas Zgonis
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
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
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
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
Lower Extremity Complex Trauma And Complications., John Stapleton
John J Stapleton DPM, FACFAS
No abstract provided.
Surgical Management Of Diabetic Foot Infections And Amputations., Thomas Zgonis, John Stapleton, Valerie A Girard-Powell, Ryan T Hagino
Surgical Management Of Diabetic Foot Infections And Amputations., Thomas Zgonis, John Stapleton, Valerie A Girard-Powell, Ryan T Hagino
John J Stapleton DPM, FACFAS
The incidence of diabetes with severe foot infections (eg, necrotizing fasciitis, gas gangrene, ascending cellulitis, infection with systemic toxicity or metabolic instability) has risen significantly during the past decade. Foot infections are a major cause of hospitalization and subsequent lower extremity amputation among patients with diabetes mellitus who have a history of a preexisting ulceration. Surgical management often is required to address severe diabetic foot infections because they can be limb- or life-threatening. Critical limb ischemia, neuropathy, and an immunocompromised host, which often are associated with diabetic foot infections, complicate treatment and are associated with a poorer prognosis.
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
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
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.
Total Extrusion Of The Cuboid: A Case Report, John Stapleton
Total Extrusion Of The Cuboid: A Case Report, John Stapleton
John J Stapleton DPM, FACFAS
No abstract provided.
Surgical Treatment Of Calcaneal Fracture Malunions And Posttraumatic Deformities., John Stapleton, Ronald Belczyk, Thomas Zgonis
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 …
Simultaneous Surgical Repair Of A Tibialis Anterior Tendon Rupture And Diabetic Charcot Neuroarthropathy Of The Midfoot: A Case Report, John Stapleton
Simultaneous Surgical Repair Of A Tibialis Anterior Tendon Rupture And Diabetic Charcot Neuroarthropathy Of The Midfoot: A Case Report, John Stapleton
John J Stapleton DPM, FACFAS
The combination of simultaneous rupture of a tibialis anterior tendon and Charcot neuroarthropathy of the midfoot in a diabetic patient is a rare and challenging condition that can lead to major complications if not addressed appropriately. This article discusses a tibialis anterior tendon rupture that may have developed before or after the incidence of the diabetic Charcot neuroarthropathy midfoot deformity and raises awareness to potential spontaneous tendon ruptures that may be associated with the diabetic Charcot foot.
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.
Complications And Revisional Hallux Valgus Surgery., Ronald Belczyk, John Stapleton, Jordan P Grossman, Thomas Zgonis
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
Charcot Foot And Ankle Deformity, T. Zgonis, John Stapleton, T. Roukis
John J Stapleton DPM, FACFAS
No abstract provided.
Diabetic Charcot Neuroarthropathy Of The Foot And Ankle With Osteomyelitis., Crystal L Ramanujam, John Stapleton, Thomas Zgonis
Diabetic Charcot Neuroarthropathy Of The Foot And Ankle With Osteomyelitis., Crystal L Ramanujam, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis.
Management Of Diabetic Neuropathic Foot And Ankle Malunions And Nonunions., John Stapleton
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 …
The Role Of An Extended Medial Column Arthrodesis For Charcot Midfoot Neuroarthropathy., Claire M Capobianco, John Stapleton, Thomas Zgonis
The Role Of An Extended Medial Column Arthrodesis For Charcot Midfoot Neuroarthropathy., Claire M Capobianco, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
The etiology of diabetic Charcot neuroarthropathy involving the midfoot often includes an inciting traumatic event or repetitive micro-trauma from an uncompensated biomechanical imbalance that potentiates an incompletely understood pathway leading to a rocker-bottom foot deformity and ulceration. In the setting of a severe Charcot foot fracture and/or dislocation with obvious osseous instability, diagnostic delay can potentiate the limb-threatening sequelae of infected midfoot ulcerations in this patient population. In this article, the authors discuss the thought process as well as the advantages of performing an extended medial column arthrodesis for selected Charcot midfoot deformities.
Supramalleolar Osteotomy And Ankle Arthrodiastasis For Juvenile Posttraumatic Ankle Arthritis., John Stapleton, Thomas Zgonis
Supramalleolar Osteotomy And Ankle Arthrodiastasis For Juvenile Posttraumatic Ankle Arthritis., John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Numerous techniques have been described for posttraumatic ankle arthritis with or without an associated lower extremity deformity in the adult population. These surgical procedures may include, but are not limited to, ankle exostectomy with joint resurfacing, ankle arthrodiastasis, ankle arthroplasty, and ankle arthrodesis. Associated deformities may also be addressed with supramalleolar osteotomies, tibia or fibular lengthening, and calcaneal osteotomies. In juvenile patients, surgical treatment options for posttraumatic ankle arthritis can be challenging, especially when an associated deformity is present. This article describes a combined supramalleolar osteotomy and ankle arthrodiastasis for a juvenile patient with posttraumatic ankle arthritis and valgus deformity.
Plastic Surgical Techniques For The Foot And Ankle, John Stapleton, Crystal Ramanujam
Plastic Surgical Techniques For The Foot And Ankle, John Stapleton, Crystal Ramanujam
John J Stapleton DPM, FACFAS
No abstract provided.
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.
Concomitant Osteomyelitis And Avascular Necrosis Of The Talus Treated With Talectomy And Tibiocalcaneal Arthrodesis, John Stapleton, Thomas Zgonis
Concomitant Osteomyelitis And Avascular Necrosis Of The Talus Treated With Talectomy And Tibiocalcaneal Arthrodesis, 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.
Plantar Foot Donor Site As A Harvest Of A Split-Thickness Skin Graft., Ronald Belczyk, John Stapleton, Peter A Blume, Thomas Zgonis
Plantar Foot Donor Site As A Harvest Of A Split-Thickness Skin Graft., Ronald Belczyk, John Stapleton, Peter A Blume, Thomas Zgonis
John J Stapleton DPM, FACFAS
The authors present a minimally invasive procedure for harvesting a split thickness skin graft (STSG) from the plantar surface of the foot. This is another option to consider for soft tissue reconstruction of diabetic foot wounds to help restore form and function and to prevent amputation. The authors do not recommend this technique for all soft tissue wounds of the toes and plantar aspect of the foot but believe it is a viable option for selected small diabetic foot wounds that may benefit from a STSG.
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.
Current Surgical Approaches To The Diabetic Charcot Foot And Ankle Reconstruction In The United States, C. Ramanujam, Z. Facaros, John Stapleton, T. Zgonis
Current Surgical Approaches To The Diabetic Charcot Foot And Ankle Reconstruction In The United States, C. Ramanujam, Z. Facaros, John Stapleton, T. Zgonis
John J Stapleton DPM, FACFAS
No abstract provided.