Physical Activity Assessment in the Charcot Population.

Charcot neuroarthropathy is a degenerative disorder that significantly impairs a patient's functional capacity. It has been reported that a Charcot patient's quality of life is significantly impacted by the disease state. The aim of this study is to compare measured energy expenditure to a patient's perceived quality of life and physical ability. The study enrolled 43 patients by set inclusion and exclusion criteria. Patients' total energy expenditure was measured with doubly labeled water. The patients also completed 2 quality of life assessments: 36-Item Short Form Survey (SF-36) and International Physical Activity Questionnaire-Long Form (IPAQ-LF). The measured energy expenditure was then compared to the patient's perceived functional capacity. Scores reaching statistical significance included general health (60 ± 21; p = .011), pain (62 ± 27; p = .025), emotional (61 ± 40; p < .017), physical limitation (45 ± 39; p < .0001), and physical function (50 ± 29; p < .001). SF-36 survey variables that did not reach statistical significance included mental (73 ± 26; p = .690), energy (55 ± 21; p = .205), and social (74 ± 26; p = .105). The IPAQ-LF and physical activity level (PAL) were compared. No identified variation was noted between the 2 test methods (p = .57). The patients' PAL was measured at 1.4 ± 0.42, which is comparable to the general population. Data from this study identify the Charcot population as comparable to the general population. The inferences taken from this study indicate that this population suffers from poor health outlooks compared with the general population but may be overestimating the level of perceived disability.

Sural Flap Use for the Treatment of Wounds With Underlying Osteomyelitis: Graft Size a Predictor in Outcome, a Systematic Review.

The sural flap procedure is a versatile technique that can be used to cover many types of defects about the lower extremity. The management of soft tissue defects of the lower extremity with underlying osteomyelitis is difficult. The goal for any of these patients is to create a biomechanically stable foot for weight-bearing purposes with no continued infection. Data were gathered using multiple databases from the years 2000 to 2016. Data were compiled looking at the number of subjects, age, comorbidities, number of complications, number of failures, and average flap size of complications/failures. A total of 110 patients were gathered using 5 separate articles. Twenty-two of the 110 patients had short-term complications. Flap failure was seen in 9/110 patients. A significant difference was noticed in flap size between flap failure and complication groups and nonfailure groups. The average flap size of patients who had some form of complication or failure was 51.87 cm2 in size. The average graft size for patients without complications during their recovery was 36.54 cm2. Within our study, the failure rate of 8.9% and complication rate of 13.7% are consistent with previous reports on sural perforator flaps. Last, with regard to the effect of flap size, there were significant differences between patients with a successful outcome and those who experienced complications or failures. LEVELS OF EVIDENCE: Therapeutic, Level III: Systematic review.