Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate functio...Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate function. Methods: The procedure consists of fusion of the subtalar joint, talonavicular joint and calcaneocuboid joint [1]. The procedure is traditionally done with internal fixation, however, Marinet al. has shown it to be performed with external fixation [2]. Dr. Marin and the associates have developed an alternative technique to perform a triple arthrodesis using internal and external fixation. This paper describes a step-by-step technique to perform a triple arthrodesis with both internal and external fixation. It will demonstrate the use of the prefabricated arches on the footplate for more precise and accurate placement of transosseous wires using arch-wire technique [3]. Results/Conclusion: We believe this technique will not only help increase the ability to achieve fusion with a less chance of non-union, but may also decrease healing time, which may allow patients to be mobile from the first week post-operatively and may diminish the risks associated with being non-weightbearing.展开更多
Introduction: The diabetic foot is a real public health problem due to its economic and functional impact with a high risk of amputations. The objective was to determine the podiatric risk of type 2 diabetics accordin...Introduction: The diabetic foot is a real public health problem due to its economic and functional impact with a high risk of amputations. The objective was to determine the podiatric risk of type 2 diabetics according to the classification of the International Working Group on the Diabetic Foot (IWGDF) in order to put in place suitable prevention measures. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted over 12 months from May 01, 2018 to May 01, 2019 and concerning subjects with type 2 diabetes regularly followed up at the Marc Sankale Center at Abass Ndao Hospital in Dakar. Results: Two hundred (200) patients were collected with an average age of 58.9 ± 10 years, a sex ratio of 0.43. The majority of our patients had diabetes less than 5 years of age (52%) and were on non-insulin medication (63%). The average HbA1c level was 8.1%. Besides diabetes, high blood pressure and dyslipidemia were the most common cardiovascular risk factors in 65% and 25%, respectively. The main podiatric risk factors were: neuropathy (75.5%), arteriopathy (31.5%), deformities (19.5%), history of ulceration (24%) and amputation (2%). Factors associated with the risk of ulceration were: walking barefoot (42%), wearing tight shoes (26.5%), wearing unsuitable socks (46%), gait disturbance (39%), traumatic pedicure (3.5%). The podiatric risk assessment according to the IWGDF grading had identified a podiatric risk foot in 80% of the cases. Depending on the grade of injury, it was a grade 0 (20%), grade 1 (32%), grade 2 (34%) and grade 3 (14%) risky foot. A significant correlation was established between the onset of diabetic foot and age (p p p Conclusion: Podiatric assessment remains an essential point in the fight against complications of diabetes. This study demonstrates the high risk of developing diabetic foot, hence the importance of good grade planning to reduce the impact.展开更多
文摘Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate function. Methods: The procedure consists of fusion of the subtalar joint, talonavicular joint and calcaneocuboid joint [1]. The procedure is traditionally done with internal fixation, however, Marinet al. has shown it to be performed with external fixation [2]. Dr. Marin and the associates have developed an alternative technique to perform a triple arthrodesis using internal and external fixation. This paper describes a step-by-step technique to perform a triple arthrodesis with both internal and external fixation. It will demonstrate the use of the prefabricated arches on the footplate for more precise and accurate placement of transosseous wires using arch-wire technique [3]. Results/Conclusion: We believe this technique will not only help increase the ability to achieve fusion with a less chance of non-union, but may also decrease healing time, which may allow patients to be mobile from the first week post-operatively and may diminish the risks associated with being non-weightbearing.
文摘Introduction: The diabetic foot is a real public health problem due to its economic and functional impact with a high risk of amputations. The objective was to determine the podiatric risk of type 2 diabetics according to the classification of the International Working Group on the Diabetic Foot (IWGDF) in order to put in place suitable prevention measures. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted over 12 months from May 01, 2018 to May 01, 2019 and concerning subjects with type 2 diabetes regularly followed up at the Marc Sankale Center at Abass Ndao Hospital in Dakar. Results: Two hundred (200) patients were collected with an average age of 58.9 ± 10 years, a sex ratio of 0.43. The majority of our patients had diabetes less than 5 years of age (52%) and were on non-insulin medication (63%). The average HbA1c level was 8.1%. Besides diabetes, high blood pressure and dyslipidemia were the most common cardiovascular risk factors in 65% and 25%, respectively. The main podiatric risk factors were: neuropathy (75.5%), arteriopathy (31.5%), deformities (19.5%), history of ulceration (24%) and amputation (2%). Factors associated with the risk of ulceration were: walking barefoot (42%), wearing tight shoes (26.5%), wearing unsuitable socks (46%), gait disturbance (39%), traumatic pedicure (3.5%). The podiatric risk assessment according to the IWGDF grading had identified a podiatric risk foot in 80% of the cases. Depending on the grade of injury, it was a grade 0 (20%), grade 1 (32%), grade 2 (34%) and grade 3 (14%) risky foot. A significant correlation was established between the onset of diabetic foot and age (p p p Conclusion: Podiatric assessment remains an essential point in the fight against complications of diabetes. This study demonstrates the high risk of developing diabetic foot, hence the importance of good grade planning to reduce the impact.
