Long-Term Outcomes of Hallux Amputations at Various Anatomic Levels.

Hallux amputations have long been performed for the definitive treatment of hallux osteomyelitis resulting from ulcerations. These amputations have been performed at various levels of the hallux. The aim of this study is to assess the long-term outcomes in patients with hallux amputations performed at these various levels and to determine whether there is an ideal anatomic level that would limit post-operative complications and need for revisional surgery.

Wound Debridement in Pyoderma Gangrenosum.

Background: Wound debridement improves healing in a variety of acute and chronic ulcers. However, there is concern that debridement may trigger pathergy and worsen pyoderma gangrenosum (PG).

Objective: To determine whether published evidence supports conservative wound debridement for PG.

Final efficacy and cost analysis of a fish skin graft vs standard of care in the management of chronic diabetic foot ulcers: a prospective, multicenter, randomized controlled clinical trial.

Introduction: DFUs remain a cause of significant morbidity.

Objective: This is the third of 3 planned articles reporting on a prospective, multicenter, randomized controlled trial evaluating the use of omega-3-rich acellular FSG compared with CAT in the management of DFUs.

Materials And Methods: A total of 102 patients with a DFU (n = 51 FSG, n = 51 CAT) participated in the trial as ITT candidates, with 77 of those patients included in the PP analysis (n = 43 FSG, n = 34 CAT).

Evaluating the effect of omega-3-rich fish skin in the treatment of chronic, nonresponsive diabetic foot ulcers: penultimate analysis of a multicenter, prospective, randomized controlled trial.

Objective: This is the second of 3 planned articles reporting on a prospective, multicenter, randomized controlled trial assessing the efficacy of fish skin graft in the management of diabetic foot ulcers in comparison with the standard of care (collagen alginate dressing).

Materials And Methods: The primary end point of this prospective randomized trial is the number of closed wounds at 12 weeks.

Results: As of the time of this writing, 94 patients had completed the protocol.

A Multicenter, Blinded, Randomized Controlled Clinical Trial Evaluating the Effect of Omega-3-Rich Fish Skin in the Treatment of Chronic, Nonresponsive Diabetic Foot Ulcers.

Introduction: Omega-3-rich fish skin grafts have been shown to accelerate wound healing in full-thickness wounds.

Objective: The goal of this study was to compare the fish skin graft with standard of care (SOC) using collagen alginate dressing in the management of treatment-resistant diabetic foot ulcers (DFUs), defined as superficial ulcers not involving tendon capsule or bone.

Materials And Methods: Patients with DFUs who were first treated with SOC (offloading, appropriate debridement, and moist wound care) for a 2-week screening period were then randomized to either receiving SOC alone or SOC plus fish skin graft applied weekly for up to 12 weeks.

Implantation of cryopreserved umbilical cord allograft in hard-to-heal foot wounds: a retrospective study.

Objective: The objective of this study was to assess the clinical effectiveness of surgically implanted cryopreserved human umbilical cord allograft in treating hard-to-heal wounds with and without osteomyelitis.

Method: In this single-centre, retrospective investigation, wounds (average size 6.9±10.

Use of cryopreserved umbilical cord with negative pressure wound therapy for complex diabetic ulcers with osteomyelitis.

Objective: The objective of this study was to evaluate the combined use of cryopreserved human umbilical cord (cUC) allograft and negative pressure wound therapy (NPWT) in treating complex diabetic foot ulcers (DFUs) with bone exposure and osteomyelitis. These types of wound are known to carry a high morbidity and mortality.

Methods: A single-center, retrospective chart review was performed to assess the efficacy of the combined use of cUC with NPWT, by the same surgeon, to help promote the closure of complex DFUs presenting with biopsy-proven osteomyelitis.

A single-centre, retrospective study of cryopreserved umbilical cord/amniotic membrane tissue for the treatment of diabetic foot ulcers.

Objective: Histopathological studies have shown a prolonged inflammatory phase in wounds of patients with diabetes, delaying formation of mature granulation tissue and reducing wound tensile strength, making these wounds difficult for physicians to heal. Cryopreserved human umbilical cord (cUC) tissues possess unique anti-inflammatory and anti-scarring properties and have been found to help improve closure of these chronic wounds.

Method: A retrospective chart review was performed to assess the efficacy of cUC as an advanced treatment modality to help promote the closure of chronic DFUs.

Immediate Weightbearing of First Metatarsophalangeal Joint Fusion Comparing Buried Crossed Kirschner Wires Versus Crossing Screws: Does Incorporating the Sesamoids Into the Fusion Contribute to Higher Incidence of Bony Union?

First metatarsophalangeal joint (MTPJ) arthrodesis remains a commonly used and reliable procedure for a variety of pathologies of the first MTPJ. Many costly fixation constructions have been described to achieve union with first MTPJ arthrodesis. We hypothesized that the incidence of union would be the same for both buried Kirchner (K)-wire and solid crossed screw fixation with immediate weightbearing.

Narrowing the normal range for lateral ankle ligament stability with stress radiography.

Stress radiographs are commonly performed to evaluate lateral ankle ligament stability; however, little agreement exists on the physiologic limits obtained from the anterior drawer and talar tilt stress tests. Published studies have reported the normal range for the anterior drawer test to be 3 to 10 mm and the normal range for the talar tilt test to be 0° to 23° for the uninjured ankle, leading to inconsistent interpretation. The primary objective of the present study was to narrow the threshold for the diagnosis of ankle ligament injury using stress radiographs by refining the values seen in the normal ankle.