Illgner, Ulrich, Budny, Tymo, Frohne, Inna, Osada, Nani, Siewe, Jan and Wetz, Hans H. (2014). Clinical benefit and improvement of activity level after reconstruction surgery of Charcot feet using external fixation: 24-months results of 292 feet. BMC Musculoskelet. Disord., 15. LONDON: BIOMED CENTRAL LTD. ISSN 1471-2474
Full text not available from this repository.Abstract
Background: Reconstruction of Charcot feet remains a surgical challenge. The goal of this study was to investigate safety and clinical benefit from reconstruction of Charcot feet using an external fixator. There is limited valid data regarding long-term outcomes for Charcot foot procedures. Methods: In a retrospective study, 292 Charcot feet (282 patients) undergoing reconstructive procedures in our clinic from 1996-2010 were included (93 female, 189 male, mean age 57.9 years). Average follow-up was 24.1 months. Exclusion criteria were previous major amputation on the same side. All patients underwent surgery using a Hoffmann II external fixator for six to eight weeks with offloading. The fixator was then removed, and a customized AFO with full weight bearing was applied for another 11 months. After one year, patients received customized orthopedic shoes. Results: Initial amputations were avoided. Patient activity improved significantly by more than 1 level (SD 0.67, p <.001) according to the Hoffer activity score for lower limb amputees. The most common minor complication was persistent or recurrent ulceration in 67 feet (23%). Secondary amputation (after failure of external fixation) was required in only 12 patients (6.2%). Orthopedic shoes were used by approximately 34% of patients 18 months after surgery. Conclusions: Reconstructive surgery of Charcot feet using external fixation is a safe and economically feasible procedure. Activity levels improved significantly by more than 1 level (p < 0.01), severe complications were rare, and secondary amputation was required in only 12 patients (6.2%) of a high-risk patient population. Use of an external fixator offers the advantage that all extraneous material is removed after six weeks; thus, there is no risk of broken screws or plates and the associated potential complications.
Item Type: | Journal Article | ||||||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-423078 | ||||||||||||||||||||||||||||
DOI: | 10.1186/1471-2474-15-392 | ||||||||||||||||||||||||||||
Journal or Publication Title: | BMC Musculoskelet. Disord. | ||||||||||||||||||||||||||||
Volume: | 15 | ||||||||||||||||||||||||||||
Date: | 2014 | ||||||||||||||||||||||||||||
Publisher: | BIOMED CENTRAL LTD | ||||||||||||||||||||||||||||
Place of Publication: | LONDON | ||||||||||||||||||||||||||||
ISSN: | 1471-2474 | ||||||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||||||
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URI: | http://kups.ub.uni-koeln.de/id/eprint/42307 |
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