RESUMO
Background. The use of circular external fixation is a fundamental necessity in the armamentarium of a lower limb orthoplastic reconstructive surgeon. External fixation offers orthoplastic surgeons the ability to address soft tissue and osseous defects simultaneously. Using Ilizarov principles, the reconstructive surgeon must have the ability to address unique scenarios when performing orthoplastic principles. This article offers practical surgical management concepts based on experience using the TL-Hex Orthofix Truelok Hexapod System for acute shortening and relengthening. A soft tissue and osseous defect can be managed through this surgical approach as a limb salvage alternative to amputation. The information provided will lead to improved management strategies and outcomes for the practitioner and patient when presented with soft tissue and osseous defects.
RESUMO
It is important to be properly evaluated for shoes to avoid complications. Ill-fitting shoes can lead to pathologies in different populations. The focus of this article is to review the components and function of a basic athletic-type shoe, general shoe-fitting techniques, and selecting appropriate footwear for various populations including those with diabetes, elderly, and females. Poorly fitting shoes can exacerbate structural foot deformities. Unevenly distributed plantar pressures and wear can lead to ulcerations in diabetic populations. Resources and transportation may impact the elderly population when obtaining new shoes. Esthetics is of superior consideration for females. The Brannock Device measurements are important to ensure a correct fit in guiding shoe selection. The orthopaedic nurse should be able to recognize foot ailments caused by ill-fitting shoe gear. Seeking the advice of a podiatrist should be considered before purchasing shoes.
