Podiatry Commons^™

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

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

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

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

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

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.

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

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.

Addressing Psychosocial Aspects Of Care For Patients With Diabetes Undergoing Limb Salvage Surgery., Thomas S Roukis, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Surgeons provide a key role in improving the life of patients with diabetes-related foot complications who undergo limb salvage surgery as an alternative to amputation. An integrated multidisciplinary approach is essential to improve the emotional well-being of these patients to avoid potential complications that may prolong their convalescence and further degrade their psychosocial welfare. The authors attempt to increase awareness of critical preoperative risk factors that should be obtained by a thorough comprehensive psychosocial evaluation. In addition, this article discusses how to interact with the patient and his or her family throughout the perioperative period, assisting the patient in managing …

Simultaneous Analysis Of T Helper Subsets (Th1, Th2, Th9, Th17, Th22, Tfh, Tr1 And Tregs) Markers Expression In Periapical Lesions Reveals Multiple Cytokine Clusters Accountable For Lesions Activity And Inactivity Status, Ana Claudia Araujo-Pires, Carolina Favaro Francisconi, Cláudia Cristina Biguetti, Franco Cavalla, Andreza Maria Fabio Aranha, Ariadne Letra, Ana Paula Favaro Trombone, Marcelo Faveri, Renato Menezes Silva, Gustavo P. Garlet

School of Podiatric Medicine Publications and Presentations

Previous studies demonstrate that the balance between pro- and anti-inflammatory mediators determines the stable or progressive nature of periapical granulomas by modulating the balance of the osteoclastogenic factor RANKL and its antagonist OPG. However, the cytokine networks operating in the development of periapical lesions are quite more complex than what the simple pro- versus anti-inflammatory mediators' paradigm suggests. Here we simultaneously investigated the patterns of Th1, Th2, Th9, Th17, Th22, Thf, Tr1 and Tregs cytokines/markers expression in human periapical granulomas.

Methods:

The expression of TNF-α, IFN-γ, IL-17A, IL23, IL21, IL-33, IL-10, IL-4, IL-9, IL-22, FOXp3 markers (via RealTimePCR array) was …

Elderly Foot Care, Helen Chu

International Conference: Overcoming Challenges in Active Ageing

No abstract provided.

Dramatically Increased Musculoskeletal Ultrasound Utilization From 2000 To 2009, Especially By Podiatrists In Private Offices, Richard E. Sharpe, Levon N. Nazarian, Laurence Parker, Vijay Rao, David C. Levin

Department of Radiology Faculty Papers

PURPOSE: Over the past two decades, musculoskeletal (MSK) ultrasound has emerged as an effective means of diagnosing MSK pathologies. However, some insurance providers have expressed concern about increased MSK ultrasound utilization, possibly facilitated by the low cost and ready availability of ultrasound technology. The purpose of this study was to document trends in MSK ultrasound utilization from 2000 to 2009 within the Medicare population.

METHODS: Source data were obtained from the CMS Physician/Supplier Procedure Summary Master Files from 2000 to 2009, and records were extracted for procedures for extremity nonvascular ultrasound. We analyzed annual volume by provider type using specialties, …