RE: The effect on ankle dorsiflexion of gastrocsoleus recession, Pinney SJ, et al., Foot Ankle Int. 23(1):26-29, 2002.
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Between 1993 and 1994 the value of the "Artroflow" device in deep venous thrombosis was tested in 95 trauma surgical high risk patients. Parallel to the application of Heparin and physical methods, the "Artroflow" device was employed. The test and compare group showed an equal amount of risk parameters and comparable injuries. In all patients until full mobilization a weekly clinical examination, a compression sonography of the deep leg veins and a venous Doppler examination was performed. In the test group 1 deep venous thrombosis (2.3%) and no clinically manifest lung embolism occurred. In the control group, the deep venous thrombosis rate was 21.6%. This showed a highly significant drop of the deep venous thrombosis rate in trauma surgical patients (p < 0.0041 Fisher test) and allows us to suggest the use of the "Artroflow" device in high risk patients parallel to heparin prophylaxis.
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Foot ulcerations, infections, and Charcot neuropathic osteoarthropathy are three serious foot complications of diabetes mellitus that can too frequently lead to gangrene and lower limb amputation. Consequently, foot disorders are one of the leading causes of hospitalization for persons with diabetes and can account for expenditures in the billions of dollars annually in the U.S. alone. Although not all foot complications can be prevented, dramatic reductions in their frequency have been obtained through the implementation of a multidisciplinary team approach to patient management. Using this concept, the authors present a Clinical Practice Guideline for diabetic foot disorders based on currently available evidence. The underlying pathophysiology and treatment of diabetic foot ulcers, infections, and the diabetic Charcot foot are thoroughly reviewed. Although these guidelines cannot and should not dictate the standard of care for all affected patients, they are intended to provide evidence-based guidance for general patterns of practice. The goal of a major reduction in diabetic limb amputations is certainly possible if these concepts are embraced and incorporated into patient management protocols.
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