Fibulectomy, Tibial Shortening, and Ankle Arthrodesis as an Alternative Treatment of Nonhealing Wounds Following Open Ankle Fracture in Compromised Elderly Adults

Permanent deformity and disability can occur in diabetic Charcot arthropathy (neuropathic arthropathy) if not diagnosed and treated promptly. We report two patients with uncontrolled diabetes mellitus in whom the diagnosis of ankle neuro-arthropathy was delayed by up to six months, with misdiagnoses including ankle arthritis, osteomyelitis and cellulitis. The clinical scenario and appearances of the ankle and foot were typical of Charcot arthropathy. Unfortunately, both of them sustained ankle fracture-dislocation without a history of significant trauma. Both the patients were treated by ankle arthrodesis (fusion of joint). Prevention and early diagnosis of diabetic foot is the key to avoid the development of complications. In diabetic patients, a higher index of suspicion for the possibility of Charcot’s disease is needed. Key Words: Diabetes mellitus; Charcot arthropathy; ankle fracture-dislocation; arthrodesis. DOI: 10.3329/imcj.v4i2.6503Ibrahim Med. Coll. J. 2010; 4(2): 83-86

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Primary Arthrodesis for Diabetic Ankle Fractures

Foot & Ankle Orthopaedics ◽

10.1177/2473011420908841 ◽

2020 ◽

Vol 5 (1) ◽

pp. 247301142090884

Author(s):

Caleb W. Grote ◽

William Tucker ◽

Kelly Stumpff ◽

Mitchell C. Birt ◽

Greg A. Horton

Keyword(s):

Treatment Option ◽

Complication Rate ◽

Ankle Fracture ◽

Diabetes Complications ◽

Ankle Arthrodesis ◽

Ankle Fractures ◽

Wound Complications ◽

Severe Injuries ◽

Patients With Diabetes ◽

Diabetes Patients

Background: Treatment of ankle fractures in patients with diabetes is associated with increased complication rates. Ankle arthrodesis is considered a salvage procedure after failed ankle fracture fixation, yet primary ankle arthrodesis has been proposed as a treatment option for patients with significant diabetes-related complications. To date, the characteristics of patients who undergo primary ankle arthrodesis and the associated outcomes have not been described. Methods: A retrospective review was performed of 13 patients with diabetes who underwent primary arthrodesis for traumatic ankle fracture. Patient demographics were characterized in addition to their diabetes complications, Adelaide Fracture in the Diabetic Ankle (AFDA) score, and fracture type. Outcomes assessed included reoperation rates, infection rates, wound complications, nonunion/malunion, amputation, and development of Charcot arthropathy postoperatively. Results: Patients who underwent primary arthrodesis had high rates of diabetes complications, average AFDA scores of 6.4, and high rates of severe injuries, including 38.5% open fractures and 69.2% fracture dislocations. The overall complication rate for primary arthrodesis of ankle fractures in diabetes patients was more than 75% in this cohort. Complications included a 38.5% reoperation rate, 38.5% infection rate, 53.8% wound complication rate, and 23.1% amputation rate. Despite a high nonunion rate at the attempted fusion sites, 89.9% of fractures healed and patients had a stable extremity. Conclusion: This review is the first to characterize the epidemiology and complications of diabetes patients undergoing primary ankle arthrodesis for ankle fractures. In this cohort, patients with multiple diabetic complications and severe injuries underwent primary arthrodesis, which led to an overall high complication rate. Further research is needed to determine the appropriate treatment option for these high-risk patients, and tibiotalocalcaneal stabilization without arthrodesis may be beneficial. Level of Evidence: Level IV, retrospective case series.

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Primary Ankle Arthrodesis for Neglected Open Weber B Ankle Fracture Dislocation

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2013.09.013 ◽

2014 ◽

Vol 53 (4) ◽

pp. 446-448

Author(s):

Katherine Thomason ◽

Ashwanth Ramesh ◽

Niall McGoldrick ◽

Richard Cove ◽

James C. Walsh ◽

...

Keyword(s):

Ankle Fracture ◽

Ankle Arthrodesis ◽

Fracture Dislocation

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Abstract #903: An Alternative Treatment for a Hypogonadotropic Hypogonadism Patient with a Paradoxical Response to Testosterone Replacement

Endocrine Practice ◽

10.1016/s1530-891x(20)44601-4 ◽

2017 ◽

Vol 23 ◽

pp. 192-193

Author(s):

Adriana Gonzalez ◽

Yin Oo

Keyword(s):

Alternative Treatment ◽

Hypogonadotropic Hypogonadism ◽

Testosterone Replacement ◽

Paradoxical Response

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Generation and Associative Encoding in Young and Old Adults

Experimental Psychology (formerly Zeitschrift für Experimentelle Psychologie) ◽

10.1027/1618-3169.55.1.23 ◽

2008 ◽

Vol 55 (1) ◽

pp. 23-30 ◽

Cited By ~ 21

Author(s):

Laurence Taconnat ◽

Charlotte Froger ◽

Mathilde Sacher ◽

Michel Isingrini

Keyword(s):

Task Difficulty ◽

Generation Effect ◽

Elderly Adults ◽

Generation Task ◽

Younger Adults ◽

Old Adults ◽

Strength Of Association ◽

Target Words

Abstract. The generation effect (i.e., better recall of the generated items than the read items) was investigated with a between-list design in young and elderly participants. The generation task difficulty was manipulated by varying the strength of association between cues and targets. Overall, strong associates were better recalled than weak associates. However, the results showed different generation effect patterns according to strength of association and age, with a greater generation effect for weak associates in younger adults only. These findings suggest that generating weak associates leads to more elaborated encoding, but that elderly adults cannot use this elaborated encoding as well as younger adults to recall the target words at test.

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