Clinics in podiatric medicine and surgery
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Clin Podiatr Med Surg · Jan 2003
ReviewExternal fixators for elective rearfoot and ankle arthrodesis. Techniques and indications.
Since its introduction to the western hemisphere in the mid 1980's, Gavriel Ilizarov's ring fixator system has been studied extensively and shown to be a superior mechanical construct for stabilizing limb segments. This newfound form of external fixation has radically changed many elements of foot and ankle reconstruction, providing a modular device that can accommodate the complex limb deformities while performing multiple tasks. This article summarizes the authors' experience with compression arthrodesis of the rearfoot and ankle using external fixation.
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External fixation as a modality is a versatile and minimally invasive stabilization option that should not be forgotten even as new and specially designed implants for nearly each bone become more fashionable. As a temporary traction device, the external fixator can help condition the soft tissues and, if closed reduction was sufficient, it can stay in place for definitive treatment. ⋯ External fixation instead of plaster cast allows for better care of skin and soft tissues. External fixation also has its advantages as a minimally invasive external compression device in specific indications for arthrodesis, especially in infected cases.
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Clin Podiatr Med Surg · Apr 2002
ReviewAchilles rupture in the athlete. Current science and treatment.
Achilles tendon ruptures became increasingly common in the latter half of the 20th century. Once the diagnosis is made, the patient's goals and objectives should be clearly stated. The treatment choice should incorporate the patient's needs, desires, objectives, and functional goals to assure an optimal result.
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Regional anesthesia (RA) is the anesthetic of choice for all foot and ankle surgery. Advances in anesthetic equipment and techniques have made peripheral nerve blocks the perfect anesthetic technique for these patients, who should be educated about them in their surgeon's office. ⋯ GA has a higher morbidity and complication rate compared to RA. Performance of a peripheral nerve block, or PNB, requires proper training, equipment, and support personnel in order to handle any and all complications, including general anesthesia.
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The complete care of burns to the foot can be complex or straightforward, depending on the nature of the burn. Appropriate care requires experience and training. The keys to good management of burns to the feet are understanding the pathophysiology of burns, appropriate acute management of the burns, and appropriate initial reconstruction guided by the long-term needs of the patient.