Evaluating Iatrogenic Complications of the Total-Contact Cast: An 8-Year Retrospective Review at Cleveland Clinic.

Background: Total-contact casting is an effective method to treat various pathologic abnormalities in patients with diabetic neuropathy, but its use is frequently associated with iatrogenic complications.

Methods: The largest retrospective review to date of iatrogenic complications of total-contact casts was conducted over an 8-year period at Cleveland Clinic.

Results: In the past 8 years, 23% of patients developed complications, and the most common complication was a new heel ulcer formation.

Lower extremity amputation risk factors associated with elevated ankle brachial indices and radiographic arterial calcification.

An elevated ankle brachial index (ABI) resulting from medial artery calcification, or Mönckeberg's arteriosclerosis, is commonly seen in patients with diabetes mellitus or end-stage renal disease. Recent data have found an association between elevated ABIs and cardiovascular morbidity and mortality. The purpose of the present study was to evaluate the prognostic significance of high ABIs, poorly compressible arteries, and radiographic artery calcification compared with low ABIs in predicting lower extremity amputation and morbidity.

Evaluation of Hallux Interphalangeal Joint Arthroplasty Compared With Nonoperative Treatment of Recalcitrant Hallux Ulceration.

Patients with chronic diabetes can develop plantar hallux ulcerations secondary to neuropathy, increased pressure, and deformity. The present retrospective study evaluated the efficacy of hallux interphalangeal joint (HIPJ) arthroplasty to address recalcitrant ulceration. Two groups of patients with diabetes were compared: a surgical group of 13 patients and a nonsurgical standard therapy group of 13 patients.

Infectious Spondylodiscitis, Epidural Phlegmon, and Psoas Abscess Complicating Diabetic Foot Infection: A Case Report.

Few published case reports have cited vertebral osteomyelitis as a sequela of a diabetic foot infection. The purpose of the present report is to increase awareness of a potentially severe complication of diabetic foot ulceration: vertebral osteomyelitis and associated pathologic features. We present the case of a 63-year-old male with right calcaneal osteomyelitis who developed acute onset lower back pain with concomitant fever and chills.