In the lower extremities, surgical procedures are available to assist wounds to heal or as reconstructive procedures to prevent ulceration.
Surgical debridement, including debridement of infected bone in osteomyelitis, is often required for open wounds with non-viable tissue.
Skin grafts or flaps may aid in wound healing once a wound is devoid of all non-viable tissue,
Either arthrodesis or osteotomy may be used to correct rigid bony deformities in high-pressure areas. Correction of toe deformities, such as claw-toe, may prevent ulceration in high-pressure areas.
Tendon transfers are available to rebalance a paralytic foot, such as posterior tibialis transfer for foot drop.
Tendon release procedures, such as a tendo Achilles lengthening, will help reduce high-pressure areas.
Amputation may be required for uncontrollable sepsis, an avascular extremity or when function will be increased by prosthetic usage. |