Surgical Treatment Of Intra-Articular Calcaneal Fractures.,
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.,
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,
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.
Management Of Foot And Ankle Trauma,
2015
University of Texas Health Science - San Antonio
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.,
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.,
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.
Salvage Of The First Ray With Concomitant Septic And Gouty Arthritis By Use Of A Bone Block Joint Distraction Arthrodesis And External Fixation.,
2015
Lehigh Valley Health Network
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.,
2015
University of Texas Health Science - San Antonio
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.,
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.,
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,
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,
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.,
2015
Lehigh Valley Health Network
Lower Extremity Complex Trauma And Complications., John Stapleton
John J Stapleton DPM, FACFAS
No abstract provided.
Surgical Management Of Diabetic Foot Infections And Amputations.,
2015
University of Texas Health Science - San Antonio
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.,
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,
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.
Total Extrusion Of The Cuboid: A Case Report,
2015
Lehigh Valley Health Network
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.,
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 …
Simultaneous Surgical Repair Of A Tibialis Anterior Tendon Rupture And Diabetic Charcot Neuroarthropathy Of The Midfoot: A Case Report,
2015
Lehigh Valley Health Network
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?,
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.
