Clinics in podiatry最新文献_第9页

Clinics in podiatry Pub Date : 1984-04-01

L A Sorto

{"title":"The infected implant.","authors":"L A Sorto","doi":"","DOIUrl":"","url":null,"abstract":"In summary, I believe that when faced with a definitely diagnosed deep infection involving a joint replacement of the foot, the treatment of choice is incision and drainage of the wound with removal of the implant and all necrotic bone and soft tissue. Postoperatively, some form of drainage-promoting system should be instituted. Three techniques for promoting drainage have been discussed: open packing, which technically is the easiest to accomplish, but necessitates either delayed primary closure, healing by secondary intention, or in some cases skin grafting; this obviously increases disability time; standard closed suction irrigation, which has the advantage of primary wound closure but the disadvantage of requiring around-the-clock supervision to ensure against blockage of fluid flow, especially through the egress tube; and the Sorto modification of the one-tube in-out drainage system, which has the same advantage as closed suction irrigation (primary wound closure) without the risk of blockage of the egress tube. The key to successful management of an infected implant is immediate and aggressive treatment once a definitive diagnosis is made. Although the systemic use of antibiotics is an important adjunct in the total treatment plan, one must think in terms of altering the local environment in which the offending organisms grow and multiply. This is best accomplished by decompressing the infected wound by incision and drainage; removing all necrotic tissue or foreign bodies (that is, implants); and continuously promoting drainage postoperatively. Parenteral antibodies are only effective if the blood system through which they travel reaches the local site of infection. This cannot readily occur in the presence of increased soft-tissue tension created by an infectious process. In the words of Louis Pasteur, when dealing with an infection, \"The bacteria is nothing, it is the environment in which it grows that is everything.\"","PeriodicalId":77837,"journal":{"name":"Clinics in podiatry","volume":"1 1","pages":"199-209"},"PeriodicalIF":0.0,"publicationDate":"1984-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17592852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biomechanics of implanted joints of the foot. 足部植入关节的生物力学研究。

Clinics in podiatry Pub Date : 1984-04-01

W P Orien

引用次数: 0

Hemi-implants in foot surgery. 足部手术中的半植入物。

Clinics in podiatry Pub Date : 1984-04-01

B M Dobbs

引用次数: 0

The angled great toe implant (Swanson design/Weil modification) in the surgical reconstruction of the first metatarsophalangeal joint. 倾斜大脚趾植入物(Swanson设计/Weil改良)在第一跖趾趾关节手术重建中的应用。

Clinics in podiatry Pub Date : 1984-04-01

D J Arenson

引用次数: 0

Biomaterials in foot surgery. 足部外科生物材料。

Clinics in podiatry Pub Date : 1984-04-01

E E Frisch

引用次数: 0

A new implant for the metatarsophalangeal joint. 跖趾关节的新植入物。

Clinics in podiatry Pub Date : 1984-04-01

T Sgarlato

引用次数: 0

Total first joint replacement in hallux valgus and hallux rigidus. Long-term results in 484 cases. 拇外翻和拇僵硬的全首次关节置换术。484例的长期结果。

Clinics in podiatry Pub Date : 1984-04-01

L S Weil, R A Pollak, W L Goller

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Symposium on implants in foot surgery. 足部外科植入物研讨会。

Clinics in podiatry Pub Date : 1984-04-01

引用次数: 0

The STA operation for the pronated foot in childhood. 小儿内翻足的STA手术。

Clinics in podiatry Pub Date : 1984-04-01

S D Smith

引用次数: 0

History of implants. 植入物的历史。

Clinics in podiatry Pub Date : 1984-04-01

E G Kaplan, G S Kaplan, D M Kaplan, R K Kaplan

{"title":"History of implants.","authors":"E G Kaplan, G S Kaplan, D M Kaplan, R K Kaplan","doi":"","DOIUrl":"","url":null,"abstract":"In summary, implants are highly successful because encapsulation occurs around the implant without rejection and no other fixation is necessary. There is relatively no shortening or instability of the toe, such as a floppy toe. This seems to prevent painful stiff pseudoarthrosis or arthritis because it acts as a spacer to prevent narrowing of the joint and allows for movement. It prevents a short first toe and prevents any undesired cosmetic results, as it provides the joint with a pain-free range of motion, allowing it to become more mobile and stable. Also, ulnar implants have been used with the same indications and contraindications. The most important consideration about implant surgery is that these implants, that is, the Silastic and the Swanson design, are nonabsorbable. They will not cause tissue reaction and the fibrous encapsulation forms all that is necessary to encapsulate the implant itself; therefore, there is very little bony rejection. From recent literature and through professional experience, it has been proved that implants act primarily as a spacer. They provide a pain-free range of motion but not as well as desired. Implants provide stability to the joint, which is of the utmost importance. The Silastic implants have stood the test of time in most cases. However, the search for better biomaterials, better results, and better functions is never ending. There is a great need for continued research into this field. Podiatry must continue to maintain, contribute, and improve this research.","PeriodicalId":77837,"journal":{"name":"Clinics in podiatry","volume":"1 1","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"1984-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17457704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0