Role of Surgery in Management of Osteo-Articular Tuberculosis of the Foot and Ankle

The Open Orthopaedics Journal
Mandeep S DhillonSampat Dumbre Patil

Abstract

Tuberculosis of the foot and ankle still remains to be a significant problem, especially in the developing countries, and with an increase in incidence in immunosuppressed patients. Treatment is mainly medical using multidrug chemotherapy; surgical interventions range from biopsy, synovectomy and debridement, to joint preserving procedures like distraction in early cases, and arthrodesis of hindfoot joints and the ankle in advanced disease with joint destruction. Surgical Options: All procedures should be done after initiating appropriate medical management. The ankle is the commonest joint needing intervention, followed by the subtalar and talo-navicular joint. Forefoot TB limited to the bone rarely needs surgical intervention except when the infective focus is threatening to invade a joint. Articular disease can spread rapidly, so early diagnosis and treatment can influence the outcome. Surgical interventions may need to be modified in the presence of sinuses and active disease; fusions need compression, and implants have to be chosen wisely. External fixators are the commonest devices used for compression in active disease, but intramedullary nails better stabilize pantalar arthrodesis. Arthroscopy has become a valuable tool...Continue Reading

References

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Citations

Jan 24, 2019·Journal of Orthopaedic Surgery and Research·Xiaojun Duan, Liu Yang

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Methods Mentioned

BETA
biopsy
total ankle arthroplasty

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