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Viability of permanent PMMA spacer with combined free fasciocutaneous tissue transfer for failed charcot reconstruction: A 38 month prospective case report.

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Citation: International Journal of Surgery Case Reports. 41:174-179, 2017 Oct 04PMID: 29096337Institution: MedStar Washington Hospital CenterDepartment: Surgery/Podiatric SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleYear: 2017 ISSN:

2210-2612

Name of journal: International journal of surgery case reportsAbstract: CONCLUSION: The use of a permanent PMMA cement spacer does not preclude free tissue transfer in complex host lower extremity reconstruction. A multidisciplinary team approach is a vital component to successful salvage outcomes. Copyright (c) 2017. Published by Elsevier Ltd.DISCUSSION: The osseous deficit was addressed with the use of a permanent PMMA cement spacer. The soft tissue deficit was reconstructed with a free tissue transfer. This case report demonstrates the long term viability and utility of the use of permanent cement spacers when combined with free tissue transfer for closure of complex diabetic foot wounds. This case is an example of a multidisciplinary team approach to limb salvage with successful long term outcome; a plantigrade stable functional foot in an ambulatory highly active patient. Follow up time since initial intervention was 38 months.INTRODUCTION: Charcot Neuroarthropathy is a complex lower extremity pathology which predisposes the afflicted limb to ulcerations, osteomyelitis, and risk of major amputation. Charcot Neuroarthropathy often requires osseous reconstruction, which can be complicated with osteomyelitis and hardware infection. When soft tissue and osseous deficits must be concomitantly addressed, the use of PMMA spacers can be combined with free tissue transfers.PRESENTATION OF CASE: 71year old Caucasian male with Diabetic Charcot Neuroarthopathy underwent osseous reconstruction with internal hardware. The surgical site was complicated by acute infection, osteomyelitis, exposed hardware requiring removal, and multiple surgical debridement. The degree of soft tissue and osseous deficit post-debridement required complex reconstruction.All authors: Attinger CE, Elmarsafi T, Evans KK, Kim PJ, Steinberg JSFiscal year: FY2018Digital Object Identifier:

https://dx.doi.org/10.1016/j.ijscr.2017.08.066

Date added to catalog: 2017-12-05

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	29096337	Available		29096337

CONCLUSION: The use of a permanent PMMA cement spacer does not preclude free tissue transfer in complex host lower extremity reconstruction. A multidisciplinary team approach is a vital component to successful salvage outcomes. Copyright (c) 2017. Published by Elsevier Ltd.

DISCUSSION: The osseous deficit was addressed with the use of a permanent PMMA cement spacer. The soft tissue deficit was reconstructed with a free tissue transfer. This case report demonstrates the long term viability and utility of the use of permanent cement spacers when combined with free tissue transfer for closure of complex diabetic foot wounds. This case is an example of a multidisciplinary team approach to limb salvage with successful long term outcome; a plantigrade stable functional foot in an ambulatory highly active patient. Follow up time since initial intervention was 38 months.

INTRODUCTION: Charcot Neuroarthropathy is a complex lower extremity pathology which predisposes the afflicted limb to ulcerations, osteomyelitis, and risk of major amputation. Charcot Neuroarthropathy often requires osseous reconstruction, which can be complicated with osteomyelitis and hardware infection. When soft tissue and osseous deficits must be concomitantly addressed, the use of PMMA spacers can be combined with free tissue transfers.

PRESENTATION OF CASE: 71year old Caucasian male with Diabetic Charcot Neuroarthopathy underwent osseous reconstruction with internal hardware. The surgical site was complicated by acute infection, osteomyelitis, exposed hardware requiring removal, and multiple surgical debridement. The degree of soft tissue and osseous deficit post-debridement required complex reconstruction.

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