title: Forefoot narrowing with external fixation for problem cleft wounds.
abstract: Healing of forefoot cleft wounds can be a difficult management problem in patients with peripheral vascular disease, diabetes or both. This is a prospective review of 15 patients with these conditions with nonhealing middle-ray cleft wounds managed with a temporary mini-external fixator to close the cleft wound. Fourteen (93%) of the 15 patients had a successful obliteration of the cleft and skin coverage. Twelve (80%) of 15 were able to resume their previous level of activity with the reconstructed, mechanically sound forefoot. Fourteen (93%) of the 15 patients received hyperbaric oxygen treatments as an adjunct to wound healing. All patients avoided a transmetatarsal or higher amputation.
authors.affiliation: Department of Hyperbaric Medicine, Long Beach, CA 90801-1428, USA. mstrauss@memorialcare.org
authors.forename: Michael B
authors.initials: MB
authors.lastname: Strauss
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Bryant
authors.forename: Jack D
authors.initials: JD
authors.lastname: Hart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects*; D016267:External Fixators; D005260:Female; D005545:Forefoot, Human / Q000601:surgery*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D011446:Prospective Studies; D014034:Toes / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing