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Tendon Transfer Lower Extremity Amputation

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9 papers 25 to 100 followers
Fabian G Krause, Gilles Pfander, Julia Henning, Maziar Shafighi, Martin Weber
BACKGROUND: In Chopart-level amputations the heel often deviates into equinus and varus when, due to the lack of healthy anterior soft tissue, rebalancing tendon transfers to the talar head are not possible. Consequently, anterior and lateral wound dehiscence and ulceration may occur requiring higher-level amputation to achieve wound closure, with considerable loss of function for the patients. METHODS: Twenty-four consecutive patients (15 diabetes, 6 trauma, and 3 tumor) had Chopart's amputation and simultaneous or delayed additional ankle dorsiflexion arthrodesis to allow for tension-free wound closure or soft tissue reconstruction, or to treat secondary recurrent ulcerations...
November 2013: Foot & Ankle International
Troy J Boffeli, Kyle W Abben
Nonhealing neuropathic ulcers overlying the fifth metatarsal are frequently associated with cavus foot structure and are often complicated by osteomyelitis. Partial fifth ray amputation for metatarsal phalangeal joint ulceration and osteomyelitis is a time-proven procedure. Recurrent wounds and persistent osteomyelitis at the amputation stump or fifth metatarsal base create significant challenges in a cavus foot with neuropathy. Long-term success with removal of the entire fifth ray is largely dependent on preventing infection of the cuboid and maintaining peroneal tendon function...
September 2012: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Thomas S Roukis
Transmetatarsal amputation is a useful surgical procedure that is applicable to the treatment of the dysvascular, neuropathic, and/or traumatized forefoot. Because of the loss of the insertions of some of the extrinsic pedal musculature, transmetatarsal amputation is known to be associated with imbalance of the residual foot, and this can lead to complications related to cutaneous compromise, as well as difficulties with bracing and shoe fit. In this techniques report, we describe a combination of tendon transfers that use flexor hallucis longus and extensor digitorum longus, which can be useful in preventing pedal imbalance following transmetatarsal amputation...
May 2009: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Monica H Schweinberger, Thomas S Roukis
Transmetatarsal amputation is a viable alternative to more proximal pedal amputations or leaving a deformed partial forefoot amputation. Balancing the transmetatarsal amputation in order to correct soft-tissue deformities is an accepted approach and consists of various tendon transfers, However, in the recently re-vascularized limb or in those patients who can not undergo re-vascularization, additional incisions to balance the transmetatarsal amputation are not performed. The authors present a simple and effective technique utilizing a large diameter, cannulated screw extending from the residual first metatarsal across the midfoot and into the talus after the foot has been manually corrected, which is useful for patients undergoing transmetatarsal amputation who can not undergo soft-tissue balancing...
November 2008: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Monica H Schweinberger, Thomas S Roukis
No abstract text is available yet for this article.
November 2007: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Greg D Clark, Eric Lui, Keith D Cook
Pedal amputations are necessary procedures performed by a foot and ankle surgeon that may lead to gross positional deformities of the foot. To achieve a plantigrade foot, proper balancing of the foot is required often through the use of tendon transfers and lengthening. This article describes the basic tendon transfers needed to achieve a successful outcome when performing various pedal amputations. A case is presented in which Achilles tendon lengthening was used to heal a forefoot ulcer. A full understanding of tendon function and transfer techniques is paramount for surgeons performing pedal amputations...
July 2005: Clinics in Podiatric Medicine and Surgery
Graham A Hamilton, Lawrence A Ford, Hugo Perez, Shannon M Rush
Medical records were retrospectively reviewed for 10 patients (mean age, 48.7 years) who had a chronic, recurrent neuropathic forefoot ulceration or osteomyelitis in the presence of an abnormal metatarsal parabola. Two patients had multiple lesser metatarsal osteomyelitis, 3 patients had chronic ulceration in the presence of an abnormal metatarsal parabola, and 5 patients had previous lesser ray resection or metatarsal head resection. None of the patients had signs of skin breakdown under the first metatarsal...
January 2005: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jodi Schoenhaus, Richard M Jay, Harold Schoenhaus
After resection of bone or amputation, postoperative stump breakdown occurs frequently. Furthermore, the altered mechanics with ambulation are difficult to control with bracing and orthoses alone. During the past 10 years, the peroneus brevis tendon has been transferred to various locations in the foot after resection of the fifth metatarsal base in an effort to provide continued balance between the supinatory and pronatory forces needed for a steady gait. In patients who have had a peroneus brevis tendon transfer, the rate of postoperative ulceration and the need for further bony resection is minimal...
November 2004: Journal of the American Podiatric Medical Association
A M Reyzelman, S Hadi, D G Armstrong
For several decades, Chopart's amputation has met with some skepticism owing to reports of significant equinus deformity developing soon after the procedure is performed. However, with appropriate tendon balancing, which generally includes anterior tibial tendon transfer and tendo Achillis lengthening, this level of amputation is often more functional than slightly more distal amputations, such as Lisfranc or short transmetatarsal amputations. The authors offer a rationale for this observation, which includes a discussion of the longitudinal and transverse arch concept of the foot...
February 1999: Journal of the American Podiatric Medical Association
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