1430_Tarricone.pdf

1、Elective Surgery:Preventing UlcerationsKarla Tarricone,DPMThe University of Texas at San AntonioLets meet our surgical candidatesCase Example 1 “Healthy”26yo F Recurrent left sub-2ndmetatarsal head painful hyperkeratotic lesion.Present 2+years.Just from a hammertoe?Clinical Photos 02/2025Case Exampl

2、e 1 “Healthy”26yo F WB XR 11/2024Rigid contracture at PIP joint MTP joint is hyperextended Constant downward pressure on metatarsal head+repetitive friction/pressure Callus formation Consider:Longer 2ndmetatarsal Muscle/tendon imbalanceYou ask the patient a few more questionsmedical history,medicati

3、ons,surgeries?Yes,she had surgery to her left leg!Case Example 1 “Healthy”26yo F Trauma Hx Affecting LLE:2017 MVA-pole impaled LLE left grade 3B open tibia fracture c/b osteomyelitis9/2020 tibia debridement+removal of IM rod from tibia1/2021 I&D LLE8/2021 I&D LLE,hardware removal,wound vac applicati

4、on3/2023 Horse tripped&fell onto her left leg ORIF Femur Clinical Photo 08/2024Case Example 1 “Healthy”26yo FWB XR 05/2024Case Example 1 “Healthy”26yo F US/ABI performed 01/2025Patients Values:Left TBI 0.56Left ABI 0.69 Case Example 1 “Healthy”26yo F Patients Values:Left TBI 0.56Left ABI 0.69 Normal

5、:1.0 to 1.3.This indicates that you likely do not have PAD.Mild to Moderate PAD:0.4 to 0.9.Values in this range suggest some degree of arterial blockage.Severe PAD:1.4.An ABI above this value can be misleading.It often indicates that the arteries in your lower leg are stiff and calcified,a condition

6、 common in people with diabetes or advanced kidney disease.In this case,the ABI is not a reliable measure of blood flow,and other tests are needed to properly diagnose PAD.Cceres-Farfn L,Moreno-Loaiza M,Cubas WS.Ankle-brachial index:more than a diagnostic test?Arch Peru Cardiol Cir Cardiovasc.2021 D