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[Management of midfoot instability in Charcot foot with the ring fixator : Use of a hybrid technique with internal and external stabilization].
Oper Orthop Traumatol. 2015 Apr; 27(2):129-38.OO

Abstract

OBJECTIVE

Combination of external and internal fixation for improvement of stabilization in midfoot arthrodesis.

INDICATIONS

Charcot foot of the midfoot with/without (infection-free) ulceration.

CONTRAINDICATIONS

Severe anesthesiological risks in multimorbid patients; untreated symptomatic peripheral arterial occlusive disease; severe soft tissue infection and defect with the necessity of amputation.

SURGICAL TECHNIQUE

Performing subtractive resection arthrodesis of the midfoot with locking plates and screws combined with an external ring fixator of the foot and lower leg.

POSTOPERATIVE MANAGEMENT

Postoperative partial weight bearing with sole contact and walking frame for 3 months. Then removal of external fixator, CT scan and based on the result, staged increasing of stress load with short-leg cast over a period of 4-6 weeks. Podomechanotherapy with full weight bearing.

RESULTS

With this surgical procedure, sufficient stabilization with fully load bearing, plantigrade foot with podomechanotherapy with the help of a combined internal and external fixation is possible. Complications (pin-tract infection or dislocation) exist, but they can be controlled. High healing rate of ulceration was achieved by bony position correction and stabilization.

Authors+Show Affiliations

Schön Klinik München Harlaching, Zentrum für Fuβ- und Sprunggelenkchirurgie München, Harlachinger Str. 51, 81547, München, Deutschland, skriegelstein@schoen-klinken.de.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

ger

PubMed ID

25862128

Citation

Kriegelstein, S, et al. "[Management of Midfoot Instability in Charcot Foot With the Ring Fixator : Use of a Hybrid Technique With Internal and External Stabilization]." Operative Orthopadie Und Traumatologie, vol. 27, no. 2, 2015, pp. 129-38.
Kriegelstein S, Volkering C, Altenberger S, et al. [Management of midfoot instability in Charcot foot with the ring fixator : Use of a hybrid technique with internal and external stabilization]. Oper Orthop Traumatol. 2015;27(2):129-38.
Kriegelstein, S., Volkering, C., Altenberger, S., Kessler, S., & Walther, M. (2015). [Management of midfoot instability in Charcot foot with the ring fixator : Use of a hybrid technique with internal and external stabilization]. Operative Orthopadie Und Traumatologie, 27(2), 129-38. https://doi.org/10.1007/s00064-014-0337-9
Kriegelstein S, et al. [Management of Midfoot Instability in Charcot Foot With the Ring Fixator : Use of a Hybrid Technique With Internal and External Stabilization]. Oper Orthop Traumatol. 2015;27(2):129-38. PubMed PMID: 25862128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Management of midfoot instability in Charcot foot with the ring fixator : Use of a hybrid technique with internal and external stabilization]. AU - Kriegelstein,S, AU - Volkering,C, AU - Altenberger,S, AU - Kessler,S, AU - Walther,M, Y1 - 2015/04/10/ PY - 2014/07/29/received PY - 2014/12/18/accepted PY - 2014/12/08/revised PY - 2015/4/12/entrez PY - 2015/4/12/pubmed PY - 2016/11/9/medline SP - 129 EP - 38 JF - Operative Orthopadie und Traumatologie JO - Oper Orthop Traumatol VL - 27 IS - 2 N2 - OBJECTIVE: Combination of external and internal fixation for improvement of stabilization in midfoot arthrodesis. INDICATIONS: Charcot foot of the midfoot with/without (infection-free) ulceration. CONTRAINDICATIONS: Severe anesthesiological risks in multimorbid patients; untreated symptomatic peripheral arterial occlusive disease; severe soft tissue infection and defect with the necessity of amputation. SURGICAL TECHNIQUE: Performing subtractive resection arthrodesis of the midfoot with locking plates and screws combined with an external ring fixator of the foot and lower leg. POSTOPERATIVE MANAGEMENT: Postoperative partial weight bearing with sole contact and walking frame for 3 months. Then removal of external fixator, CT scan and based on the result, staged increasing of stress load with short-leg cast over a period of 4-6 weeks. Podomechanotherapy with full weight bearing. RESULTS: With this surgical procedure, sufficient stabilization with fully load bearing, plantigrade foot with podomechanotherapy with the help of a combined internal and external fixation is possible. Complications (pin-tract infection or dislocation) exist, but they can be controlled. High healing rate of ulceration was achieved by bony position correction and stabilization. SN - 1439-0981 UR - https://www.unboundmedicine.com/medline/citation/25862128/[Management_of_midfoot_instability_in_Charcot_foot_with_the_ring_fixator_:_Use_of_a_hybrid_technique_with_internal_and_external_stabilization]_ L2 - https://doi.org/10.1007/s00064-014-0337-9 DB - PRIME DP - Unbound Medicine ER -