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- Author or Editor: Engin Eceviz x
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Background
Although Kirschner wire implantation is popular for treating toe deformities, complications frequently occur. To prevent pin-tract infection and difficult Kirschner wire extraction, several implants have been developed to improve treatment outcomes.
Methods
Patients who had undergone an interphalangeal fusion by two-component implant for the treatment of toe deformities were included. Thirty-one toes of 21 patients were evaluated retrospectively. American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores were used in clinical evaluation.
Results
The mean operation duration per toe was 16.4 min (range, 13–26 min). The average AOFAS forefoot score was 42.76 (range, 23–57) preoperatively and 88.76 (range, 70–95) at 34.4 months (range, 26–46 months) after surgery. Mean follow-up was 14.8 months (range, 12–19 months). Compared with before surgery, the AOFAS score was increased significantly after surgery (P = .03 by t test). Three minor complications were encountered. In one patient an infection was observed. After the implants were removed (first month) she was treated successfully by debridement and antibiotic agents and, finally, Kirschner wire placement. The second patient had a fissure fracture at the proximal phalanx, but routine follow-up did not change. In the third patient, the locking mechanism had become loose (detected on day 1 radiography); it was remounted under fluoroscopy without opening the wound. No patients had a cutout, loss of alignment, recurrence, or persistent swelling.
Conclusions
Outcomes of arthrodesis using the two-component implant were found to be safe and reliable, especially for hammer toe and fifth toe deformities.
Background:
Surgical or nonsurgical treatment of an Achilles tendon rupture includes a period of immobilization that is a well-documented risk factor for deep venous thrombosis (DVT). The DVT is a source of morbidity in orthopedic surgery because it can progress to pulmonary embolism. The aim of this study was to investigate the incidence of DVT and pulmonary embolism after surgical treatment of an Achilles tendon rupture.
Methods:
A retrospective analysis was made of patients who underwent surgical treatment of Achilles tendon rupture between January 1, 2006, and November 30, 2014. Patient data were collected from the hospital medical record system.
Results:
Of 238 patients with a mean age of 39 years (range, 18–66 years), 18 (7.6%) were diagnosed as having symptomatic DVT. The average body mass index of the patients with DVT was 31.8 (range, 24–33). Of the patients with DVT, 11 were older than 40 years and two-thirds had a body mass index of 30 or greater. Pulmonary embolism was diagnosed in four patients (1.7%), none of whom had DVT symptoms.
Conclusions:
Venous thrombosis continues to be a major cause of morbidity and mortality in postoperative patients. Limited data are available for the use of thromboprophylaxis in foot and ankle surgery. In light of the literature review and results of this study, we suggest that routine thromboembolism prophylaxis should be considered for patients with Achilles tendon rupture.
