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Forefoot narrowing with external fixation for problem cleft wounds.

Michael B Strauss1, Brandon J Bryant, Jack D Hart

  • 1Department of Hyperbaric Medicine, Long Beach, CA 90801-1428, USA. mstrauss@memorialcare.org

Foot & Ankle International
|June 5, 2002
PubMed
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A mini-external fixator effectively healed nonhealing forefoot cleft wounds in 14 of 15 patients with diabetes or peripheral vascular disease, preventing amputation.

Area of Science:

  • Podiatric surgery
  • Vascular surgery
  • Diabetic foot care

Background:

  • Forefoot cleft wounds in patients with diabetes or peripheral vascular disease present significant healing challenges.
  • Nonhealing wounds in these high-risk populations often lead to severe complications, including amputation.

Purpose of the Study:

  • To evaluate the efficacy of a temporary mini-external fixator in managing nonhealing middle-ray forefoot cleft wounds.
  • To assess the functional outcomes and amputation rates in patients treated with this technique.

Main Methods:

  • Prospective review of 15 patients with nonhealing middle-ray forefoot cleft wounds.
  • Application of a temporary mini-external fixator to close the cleft wound.
  • Adjunctive use of hyperbaric oxygen therapy in most patients.

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Main Results:

  • Successful wound obliteration and skin coverage were achieved in 14 out of 15 patients (93%).
  • Twelve patients (80%) regained their previous activity levels with a reconstructed, stable forefoot.
  • All 15 patients avoided transmetatarsal or higher amputations.

Conclusions:

  • Temporary mini-external fixator application is a viable and effective treatment for nonhealing forefoot cleft wounds in high-risk patients.
  • This method facilitates wound closure, preserves foot function, and prevents major amputations.
  • Hyperbaric oxygen therapy may serve as a beneficial adjunct in managing these complex wounds.