title: Concomitant osteomyelitis and avascular necrosis of the talus treated with talectomy and tibiocalcaneal arthrodesis.
abstract: The goal with Lisfranc fracture-dislocations is to regain joint congruity and reestablish midfoot stability to avoid debilitating posttraumatic arthrosis and chronic pain in the sensate patient. In the diabetic population, dense peripheral neuropathy and/or vascular disease are equally important and may alter the surgical approach to traumatic tarsometatarsal injuries. The initial diagnosis in the diabetic population may be delayed due to subtle radiographic findings and/or patient unawareness of trauma in the insensate foot. Failure to initiate treatment in the early stages of acute diabetic neuropathic Lisfranc injuries can predispose the patient to midfoot instability, potential ulceration, infection, and Charcot neuroarthropathy.
authors: Foot and Ankle Surgery, VSAS Orthopaedics, Lehigh Valley Hospital, Allentown, PA 18103, USA.
authors: John J
authors: JJ
authors: Stapleton
authors: Thomas
authors: T
authors: Zgonis
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D001177:Arthropathy, Neurogenic / Q000150:complications / Q000000981:diagnostic imaging; D002111:Calcaneus / Q000601:surgery; D003929:Diabetic Neuropathies / Q000150:complications; D016267:External Fixators; D033023:Foot Joints / Q000000981:diagnostic imaging; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D010019:Osteomyelitis / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D010020:Osteonecrosis / Q000150:complications / Q000601:surgery*; D010348:Patient Care Team; D011859:Radiography; D018461:Soft Tissue Infections / Q000150:complications; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D013628:Talus / Q000293:injuries / Q000601:surgery; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome; D016474:Weight-Bearing