Publications by authors named "John Randolph Clements"

Pilon fractures are complex injuries that can be difficult to treat and lead to severe complications if not managed appropriately. A thorough examination for polytraumatic injuries, neurovascular status, and skin condition should be done. A variety of approaches can be chosen based on fracture pattern, including staging, incisional approach, and no-touch technique.

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Article Synopsis
  • Metatarsal fractures are common and can often be treated effectively with new surgical techniques to improve healing.
  • The main goals of treatment include keeping the metatarsal's natural shape, proper alignment of the metatarsal heads, and ensuring the metatarsophalangeal joint functions well.
  • While many metatarsal fractures can be managed without surgery, those that are displaced typically need surgical repair to maintain proper walking mechanics.
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An open label, multicenter 16-week trial of cryopreserved human umbilical cord (TTAX01) was previously undertaken in 32 subjects presenting with a Wagner grade 3 or 4 diabetic foot ulcer, with 16 (50%) of these having confirmed closure following a median of one product application (previous study). All but two subjects (30/32; 94%) consented to participate in this follow-up study to 1-year postexposure. No restrictions were placed on treatments for open wounds.

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Currently, disagreement exists regarding the superior method for repairing a ligamentous Lisfranc injury regarding whether to use arthrodesis or open reduction internal fixation. The 2 procedures differ in the amount of articular cartilage destroyed. Arthrodesis removes all the articular cartilage, and open reduction internal fixation places transarticular screws, essentially destroying a portion of cartilage.

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We present an interesting, but unfortunate, case of an 86-year-old female who sustained a trimalleolar ankle fracture dislocation that resulted in below-the-knee amputation after open reduction and internal fixation of the fracture. To the best of our knowledge, this is the first case report describing popliteal variants that ultimately resulted in critical limb ischemia and below-the-knee amputation after foot and ankle trauma. The anatomic variation altered the expected outcome from a relatively straightforward surgical case.

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Repair of segmental bone defects is an enormous challenge for foot and ankle surgeons. This report describes the case of an unusual technique for managing segmental bone voids about the ankle, namely the use of a cylindrical titanium cage packed with bone graft, and an intramedullary nail. The technique was successful at bridging a large segmental defect, and biopsy specimens procured from the length of the healed graft confirmed osseous consolidation.

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The purpose of this retrospective study was to determine the outcome of bimalleolar equivalent ankle fractures in patients who were treated nonoperatively. The charts of 214 patients with isolated Weber B (supination-external rotation pattern) fibula fractures were reviewed. Fifty-one patients met the inclusion criteria and were administered the American Orthopaedic Foot and Ankle Society Ankle and Hindfoot Functional Survey by telephone or personal interview.

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Synopsis of recent research by authors named "John Randolph Clements"

  • - John Randolph Clements' recent research primarily focuses on the management of complex foot and ankle injuries, including pilon and metatarsal fractures, where he emphasizes the selection of appropriate surgical techniques to enhance healing and patient outcomes.
  • - His studies also explore innovative treatments, such as the use of cryopreserved umbilical cord for diabetic foot ulcers, demonstrating significant healing rates and safety over a year-long follow-up period after initial treatment.
  • - Clements examines critical complications in foot and ankle surgery, including cases of unexpected outcomes from common procedures, thereby contributing valuable insights into the risks associated with anatomical variations and the challenges of fracture management.