Background: Plantar hallux IPJ ulcers are common and challenging to manage, with many available treatments. One newer technique called SPFR has been used in the management of plantar forefoot ulcers.
Objective: This case series reports the clinical results of SPFR for treatment of strictly plantar hallux IPJ ulcers.
Materials And Methods: A retrospective chart review was conducted on patients that underwent SPFR procedure by a single foot and ankle surgeon from 2018 to 2023. The primary study outcome was to identify the rate and time of healing associated with SPFR for hallux IPJ ulcers. Only the initial surgery was evaluated for time of healing for the ulcer, healing rate, and complications. Subsequent surgeries were reviewed as well. Patient charts were further reviewed to determine the presence or absence of a postoperative complication.
Results: A total of 17 feet from 17 patients were studied. The hallux IPJ ulcers healed in an average of 3.0 months. The average follow-up time was 26.9 months. Fifteen patients (88.2%) healed after the SPFR procedure. Five patients (29.4%) developed transfer lesions, and 7 patients (41.2%) developed postoperative complications.
Conclusions: The authors believe that SPFR can be utilized in the treatment of hallux IPJ ulcers if both surgeons and patients are aware of the potential complications and limitations of this procedure. Further research is warranted to evaluate the efficacy and reproducibility of these results.
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http://dx.doi.org/10.25270/wnds/23093 | DOI Listing |
Cureus
June 2024
Trauma and Orthopaedics, Epsom and St Helier University Hospitals NHS Trust/South West London Elective Orthopaedic Centre, Surrey, GBR.
Hallux interphalangeal joint (IPJ) flexion contracture is an uncommon deformity with various underlying causes, including trauma, neurological disorders, and connective tissue pathologies. We present a unique case of a 10-year-old female patient with neurofibromatosis type 1 (NF1) and a history of fibula transposition surgery, resulting in a hallux IPJ flexion contracture. We believe that the loss of the proximal fibular attachment of the extensor hallucis longus (EHL) following fibula harvesting resulted in EHL weakness and unopposed flexor hallucis longus (FHL) pull that eventually led to the contracture.
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September 2024
Faculty of Sport Sciences, Waseda University, Saitama, Japan. Electronic address:
Wounds
November 2023
Community Medical Center-RWJ Barnabas Health, Toms River, NJ; Ocean County Foot and Ankle Surgical Associates, Toms River, NJ.
Background: Plantar hallux IPJ ulcers are common and challenging to manage, with many available treatments. One newer technique called SPFR has been used in the management of plantar forefoot ulcers.
Objective: This case series reports the clinical results of SPFR for treatment of strictly plantar hallux IPJ ulcers.
Introduction: Plantar hallux wounds are common in patients with diabetic neuropathy. Several techniques, both surgical and nonsurgical, are designed to offload plantar wounds. However, controversy exists regarding which techniques are superior in terms of efficacy, safety, and longevity.
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March 2023
Division of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery and Burns, Ganga Hospital, Coimbatore, TN, India.
Background: Hallux ulcers are known for their recurrence and associated risk for future amputations. Traditional nonsurgical external offloading methods have poor compliance rates, and the data is sparse on surgical offloading of hallux ulcers. We performed this study to analyze the outcomes of Keller excision gap arthroplasty of the first metatarsophalangeal joint in patients with a neuropathic plantar hallux interphalangeal joint (IPJ) ulcer in patients with diabetes mellitus.
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