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L B Harkless

Publications and source records attributed to L B Harkless.

79 records · Page 5Linked to original sources
PubMedDate not supplied

Arthrodesis of the first metatarsophalangeal joint: a review of the literature and long-term retrospective analysis.

A retrospective analysis of arthrodesis of the first metatarsophalangeal joint was done to determine the procedure's long-term subjective and objective results. The authors reviewed the long-term results of arthrodesis in 25 patients with 32 operated feet. The average age was 54.8 years (range 22 to 72 years), and the average length of follow-up was 31.9 months (range 12 to 84 months). The patients were questioned regarding pain, activity, cosmesis, and willingness to have the operation performed again. The subjective results were good or excellent in 26 feet (81% success rate). The primary postoperative complaints were pain in the interphalangeal joint (four feet), and a callosity or pain under the first metatarsal head (four feet). Radiographic examination revealed that the procedure provided a good reduction of the hallux valgus angle (preoperative average 33.7 degrees; postoperative average 17.4 degrees) and intermetatarsal angle (preoperative average 16.2 degrees; postoperative average 12.0 degrees). The authors believe that this procedure is a reliable, effective treatment whenever stability is required at the first metatarsophalangeal joint.

Adult↗
PubMedDate not supplied

Seronegative rheumatoid arthritis and Morton's neuroma.

The authors present a case of seronegative rheumatoid arthritis and symptomatic Morton's neuroma. The thought process of the differential diagnosis is explored extensively with substantial support and review of existing literature.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Avascular necrosis after first metatarsal head osteotomies.

Thirty patients who were surgically treated for hallux valgus by first metatarsal head osteotomies between 1975 and 1980 were reviewed. The average follow-up was 41 months, with the longest being 78 months and the shortest 16 months. Radiographs were obtained to determine if avascular necrosis of the first metatarsal head had occurred. Two cases of avascular necrosis were discovered.

Adult↗
PubMedDate not supplied

Infected puncture wounds in adults with diabetes: risk factors for osteomyelitis.

The purpose of this study was to investigate factors that contribute to the development of osteomyelitis of the foot after a puncture wound in patients with diabetes. Forty-five male and 21 female adults with diabetes that were admitted to the hospital for a foot infection precipitated by a puncture were included in the study. Twenty-two (33%) patients had osteomyelitis (O) based on either a positive bone culture or pathology report. Forty-four patients had soft tissue infections (ST). Age and duration of diabetes were similar in both groups. Patients with osteomyelitis received medical treatment later than patients with soft tissue infections. A significant difference was identified when comparing the time interval from the time of the injury until patients were hospitalized and until they had the puncture wound surgically debrided, and when comparing the interval from when patients first received initial professional medical evaluation until they were hospitalized and until they had the puncture wound surgically debrided. Patients with punctures involving the forefoot (FF) and patients that wore shoes (S) at the time of the injury were more likely to develop osteomyelitis than patients that had rearfoot (RF) injuries O: FF = 20, 90%, RF = 2, 10%, ST: FF = 30, 70%, RF = 13, 30%, p < 0.05) and patients that were barefoot (B) at the time of injury (O: S = 15, 88%, B = 2, 12%, ST: S = 21, 57%, B = 16, 43%, p < 0.05). Osteomyelitis is a common complication in patients with diabetes with a foot infection following a puncture wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

The University of Texas Health Science Center at San Antonio: experience with foot surgery in diabetics.

The authors present their experience, at the University of Texas Health Science Center at San Antonio, with foot surgery in patients with diabetes mellitus. It is important to note that the results that follow are a reflection of the authors' experience with foot surgery in these patients from 1980 to 1985. The authors report two separate groups of patients: those who underwent elective foot surgery and those who underwent ablative foot surgery for an infected diabetic foot with necrosis. Also reviewed is the etiology of diabetic foot deformities and ulcerations. It has been the authors' experience that elective prophylactic surgery in patients with diabetes and an intact vascular status produces good results. Patients with an infected diabetic foot, providing they demonstrate adequate vascular status, have a high percentage of healing with early surgical intervention.

Academic Medical Centers↗
PubMedDate not supplied

Bacterial pathogens in infected puncture wounds in adults with diabetes.

Infections resulting from puncture wounds to the foot in diabetics appear not to have been previously reported in the medical literature. The purpose of this report is to describe bacterial pathogens identified from bone and soft tissue infections precipitated by a puncture injury in patients with diabetes. In a 7-year retrospective study, the authors evaluated 22 patients with osteomyelitis and 44 patients with soft tissue infections. Medical records and operative culture and sensitivity reports were reviewed. Staphylococcus aureus (68%), Streptococcus species (44%), and Enterococcus species (27%) were the most common pathogens identified. Pseudomonas was more common in cases of osteomyelitis (36%) than in soft tissue infections (18%) (p < 0.001). Pseudomonas was more common in patients that had worn tennis shoes at the time of the puncture injury compared to patients that were barefoot or who wore some other type of footwear (p < 0.001). Seventy-four percent of patients had polymicrobial infections. Anaerobes were identified in only seven patients (11%). This study suggests that polymicrobial infections with few anaerobes are common in infected puncture wounds in diabetics. Pseudomonas is more common in bone infections and is associated with wearing tennis shoes at the time of injury.

Adult↗