Forefoot narrowing with external fixation for problem cleft wounds

Foot Ankle Int. 2002 May;23(5):433-9. doi: 10.1177/107110070202300511.


Healing of forefoot cleft wounds can be a difficult management problem in patients with peripheral vascular disease, diabetes or both. This is a prospective review of 15 patients with these conditions with nonhealing middle-ray cleft wounds managed with a temporary mini-external fixator to close the cleft wound. Fourteen (93%) of the 15 patients had a successful obliteration of the cleft and skin coverage. Twelve (80%) of 15 were able to resume their previous level of activity with the reconstructed, mechanically sound forefoot. Fourteen (93%) of the 15 patients received hyperbaric oxygen treatments as an adjunct to wound healing. All patients avoided a transmetatarsal or higher amputation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation / adverse effects*
  • External Fixators*
  • Female
  • Forefoot, Human / surgery*
  • Humans
  • Hyperbaric Oxygenation
  • Male
  • Metatarsal Bones / surgery
  • Middle Aged
  • Necrosis
  • Prospective Studies
  • Toes / pathology
  • Toes / surgery*
  • Wound Healing*