Despite costing up to 5X more than a one-third tubular plate (TTP) and no absolute indications, distal fibula locking plates (DFLP) are becoming increasingly popular in the fixation of ankle fractures, particularly in the elderly. We reviewed all our distal fibula fracture fixations, over the course of one year, in order to rationalise DFLP use. Patient demographics, Weber classification, use of DFLP or TTP and the mode of fixation were recorded. Open fractures and tibial plafond fractures were excluded.Introduction
Methods
Limited forefoot amputation in diabetic patients
with osteomyelitis is frequently required. We retrospectively reviewed
diabetic patients with osteomyelitis, an unhealed ulcer and blood
pressure in the toe of >
45 mmHg who underwent limited amputation
of the foot with primary wound closure. Between 2006 and 2012, 74
consecutive patients with a mean age of 67 years (29 to 93), and
a median follow-up of 31 months, were included. All the wounds healed
primarily at a median of 37 days (13 to 210; mean 48). At a median
of 6 months (1.5 to 18; mean 353 days), 23 patients (31%) suffered
a further ulceration. Of these, 12 patients (16% of the total) required
a further amputation. We conclude that primary wound closure following limited amputation
of the foot in patients with diabetes is a safe and effective technique
when associated with appropriate antibiotic treatment. Cite this article:
