Limb Salvage by Means of Hindfoot Arthrodesis Utilizing Bulk Allograft and External Fixation.

Carl Brandon Lindberg, Rishika Lagisetti, Amol Saxena
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Abstract

Format: Retrospective Review.

Length of follow-up: 18 months.

Classification: Rearfoot and Ankle Reconstruction.

Methodology: Level 4 Retrospective Review.

Procedures: A retrospective review was performed of 6 patients who had undergone limb salvage procedures between January 2016 and April 2019. Patients underwent surgery due to severe limb-threatening diagnosis including Charcot and/or osteomyelitis. Salvage arthrodesis was performed with bulk femoral head allograft incorporation using a hexapod external fixation system. The external fixation was retained for an average of 16 weeks. All patients were followed for a postoperative period of 16 months.

Results: Successful rearfoot arthrodesis and limb salvage was achieved in ⅚ (83%) of patients.

Discussion: This review demonstrates that limb salvage and arthrodesis are possible using femoral head allograft incorporation by external fixation alone. The involved patients had resolution of the osteomyelitis and Charcot deformity, salvage arthrodesis of the rearfoot and avoidance of a major limb amputation.

Levels of evidence: IV.

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利用大块同种异体移植和外固定的后足关节成形术挽救肢体
形式随访时间:18 个月:后足和踝关节重建:4级回顾性研究:对2016年1月至2019年4月期间接受肢体挽救手术的6名患者进行了回顾性审查。患者因严重威胁肢体的诊断(包括夏科病和/或骨髓炎)而接受手术。抢救性关节置换术使用六爪外固定系统植入大块股骨头异体移植物。外固定平均维持了16周。术后对所有患者进行了长达16个月的随访:结果:83%的患者成功进行了后足关节置换术并获得了肢体挽回:讨论:本综述表明,仅通过外固定纳入股骨头同种异体移植物就能实现肢体挽救和关节固定。相关患者的骨髓炎和Charcot畸形得到了缓解,后足的关节固定得到了挽救,并避免了大肢截肢:证据等级:IV.
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