Salvage of the first ray with concomitant septic and gouty arthritis by use of a bone block joint distraction arthrodesis and external fixation

Clinics in Podiatric Medicine and Surgery
John J StapletonThomas Zgonis

Abstract

Gouty arthropathy about the first metatarsal-phalangeal joint with a superimposed deep infection poses a great challenge to the foot and ankle surgeon. The inflammatory nature of gout compromises the soft-tissue envelope and vasculature to the area. Acute gouty arthropathy is usually a contraindication to surgical intervention secondary to wound-healing complications and possible vasospasm leading to tissue necrosis. However, if deep infection is present this must be managed with adequate surgical débridement followed by delayed soft-tissue and osseous reconstruction to prevent amputation. The authors present an exceptional clinical manifestation of gouty arthropathy of the first metatarsal-phalangeal joint concomitant with deep abscess and osteomyelitis and the surgical approach taken to afford functional limb salvage.

References

Jul 1, 1995·Current Opinion in Rheumatology·A Weinberger
Aug 19, 2003·Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand·Frédéric A SchuindJean-Lambert Pasteels
Sep 21, 2004·Journal of the American Podiatric Medical Association·Thomas S Roukis, Adam S Landsman

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Citations

Jan 17, 2012·Clinics in Podiatric Medicine and Surgery·Robert M RajczySteven F Boc
Mar 17, 2018·Journal of the American Podiatric Medical Association·Kerim SariyilmazFatih Dikici
Nov 4, 2008·Journal of Wound Care·D D RhoadsS L Percival

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