INDICATIONS: Lesions limited to the forefoot when reconstruction of the forefoot is impossible. In situations where due to the unavailability of protheses a forefoot amputation has to be done.
CONTRAINDICATIONS: Absolute: Badly scarred or destroyed calcaneum and/or heel pad. Osteomyelitis of lower tibia or calcaneum. Malignancy of the heel area. Relative: Inadequate circulation of the heel area. Uncontrolled diabetes mellitus.
SURGICAL TECHNIQUE: Forefoot amputation with arthrodesis between tibia and os calcis. Specially applicable in patients with neuropathy because this simple procedure leaves a stable stump. Prosthetic fitting not mandatory. Negligible shortening of limb.
POSTOPERATIVE MANAGEMENT: Bed rest, elevation of limb, and protective splinting for 3 postoperative days. Non weight bearing on crutches for the next 2 weeks, then well fitted contact cast with Böhler iron for walking. Application of prosthesis not before bony consolidation.
POSSIBLE COMPLICATIONS: Infections. Treat very intensively.
RESULTS: Fifty modified Pirogoff procedures were done over 30 years, mostly for leprosy or malignancy. Long-term follow-up available of 16 patients who suffered from leprosy (see Figure 11).
BT - Operative Orthopadie und Traumatologie C1 - http://www.ncbi.nlm.nih.gov/pubmed/17009175?dopt=Abstract DA - 1997 Mar DO - 10.1007/s00064-006-0008-6 IS - 1 J2 - Oper Orthop Traumatol LA - eng N2 -INDICATIONS: Lesions limited to the forefoot when reconstruction of the forefoot is impossible. In situations where due to the unavailability of protheses a forefoot amputation has to be done.
CONTRAINDICATIONS: Absolute: Badly scarred or destroyed calcaneum and/or heel pad. Osteomyelitis of lower tibia or calcaneum. Malignancy of the heel area. Relative: Inadequate circulation of the heel area. Uncontrolled diabetes mellitus.
SURGICAL TECHNIQUE: Forefoot amputation with arthrodesis between tibia and os calcis. Specially applicable in patients with neuropathy because this simple procedure leaves a stable stump. Prosthetic fitting not mandatory. Negligible shortening of limb.
POSTOPERATIVE MANAGEMENT: Bed rest, elevation of limb, and protective splinting for 3 postoperative days. Non weight bearing on crutches for the next 2 weeks, then well fitted contact cast with Böhler iron for walking. Application of prosthesis not before bony consolidation.
POSSIBLE COMPLICATIONS: Infections. Treat very intensively.
RESULTS: Fifty modified Pirogoff procedures were done over 30 years, mostly for leprosy or malignancy. Long-term follow-up available of 16 patients who suffered from leprosy (see Figure 11).
PY - 1997 SP - 49 EP - 58 T2 - Operative Orthopadie und Traumatologie TI - Conservative amputation of the neuropathic foot- The Pirogoff procedure. VL - 9 SN - 0934-6694 ER -