• 1

    Centers for Disease Control and Prevention: National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020. Available at: https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html. Accessed February 1, 2020.

  • 2

    Frykberg RG, Wittmayer B, Zgonis T: Surgical management of diabetic foot infections and osteomyelitis. Clin Podiatr Med Surg 24: 469, 2007.

  • 3

    Prompers L, Huijberts M, Apelqvist J: High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia 50: 18, 2007.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 4

    Schultz GS, Sibbald RG, Falanga V: Wound bed preparation: a systematic approach to wound management. Wound Repair Regen 11(suppl 1): S1, 2003.

  • 5

    Bharara M, Mills JL, Suresh K, et al.: Diabetes and landmine-related amputations: a call to arms to save limbs. Int Wound J 6: 2, 2009.

    • Crossref
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6

    Klaphake S, de Leur K, Mulder PGh, et al.: Mortality after major amputation in elderly patients with critical limb ischemia. Clin Interv Aging 12: 1985, 2017.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 7

    Strauss MB, Bryant BJ, Hart JD: Forefoot narrowing with external fixation for problem cleft wounds. Foot Ankle Int 23: 433, 2002.

  • 8

    Oznur A, Tokgozoglu M: Closure of central defects of the forefoot with external fixation: a case report. J Foot Ankle Surg 43: 56, 2004.

  • 9

    Bevilacqua NJ, Rogers LC, DellaCorte MP, et al.: The narrowed forefoot at 1 year: an advanced approach for wound closure after central ray amputations. Clin Podiatr Med Surg 25: 127, 2008.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Chaus GW, Dukes C, Hak DJ, et al.: Analysis of usage and associated cost of external fixators at an urban level 1 trauma centre. Injury 45: 1611, 2014.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 11

    Bickels J, Kollender Y, Wittig JC, et al.: Vacuum-assisted wound closure after resection of musculoskeletal tumors. Clin Orthop Relat Res 441: 346, 2005.

A Novel Technique to Close Large Defects in the Foot Secondary to Infection Using Widely Available and Inexpensive Tools: A Case Report

View More View Less
  • 1 Rancho Los Amigos National Rehabilitation Center, Downey, CA.
  • | 2 Keck School of Medicine, Los Angeles, CA.
Restricted access

One of the challenges after central ray resection is a large soft-tissue defect. Many authors have reported the use of external fixators as a means of narrowing the forefoot. Ours is the first article to report an interesting case using widely available and inexpensive tools such as Kirschner and cerclage wires as an external fixation means of narrowing the forefoot after a complete second-ray resection and extensive soft-tissue debridement for a severe diabetic foot ulcer. This simple yet inexpensive technique is easy to perform for any foot and ankle surgeon at any hospital or surgical center.

Corresponding author: Ngan T. Nguyen, DPM, Rancho Los Amigo Rehabilitation Center, 7601 E Imperial Hwy, Downey, CA 90242. (E-mail: ngannguyens@gmail.com)