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Ankle Infections: Postoperative and Septic Arthritis

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Evaluation and Surgical Management of the Ankle

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Abstract

The ankle represents a relatively common location for infections whether arising de novo or postoperatively owing to the peripheral and dependent location. A thorough knowledge of evaluation, diagnostic, and treatment options for ankle infections will serve any orthopaedic surgeon well. Infections can be stratified based upon depth of involvement, as well as the chronicity, and each of these has treatment implications. The evaluation of infections is guided by a clinician’s index of suspicion and working knowledge of risk factors and proceeds in a careful linear fashion with laboratory and imaging guided by a thorough history and physical. Ultimately the goal of management of all infections is the eradication of the infecting organism, maintenance of a healthy soft tissue envelope, preservation of bone and chondral surfaces, restoration of function, and mitigation of side effects of treatment. Organism identification via deep culture is central to diagnosis in all but superficial cellulitis. The tenets of operative treatment include a thorough surgical debridement, evaluation of hardware function, assessing tissue viability, dead space and soft tissue defect management. High rates of infection eradication can be expected through a careful protocolized approach, however functional outcomes may suffer due to soft tissue and joint damage.

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Authors and Affiliations

  1. Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ, USA

    Joseph D. Galloway & Michael S. Sirkin

  2. Department of Orthopaedics, SUNY Downstate, Brookdale Hospital, Brooklyn, NY, USA

    Emily E. Wild

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  1. Joseph D. Galloway
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  2. Emily E. Wild
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  3. Michael S. Sirkin
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Editors and Affiliations

  1. Center for Bone and Joint Disease, Hudson, FL, USA

    Dolfi Herscovici Jr.

  2. Hughston Orthopedic Trauma, Indianapolis, IN, USA

    Jeffrey O. Anglen

  3. Texas Orthopaedic Associates, Dallas, TX, USA

    John S. Early

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Galloway, J.D., Wild, E.E., Sirkin, M.S. (2023). Ankle Infections: Postoperative and Septic Arthritis. In: Herscovici Jr., D., Anglen, J.O., Early, J.S. (eds) Evaluation and Surgical Management of the Ankle. Springer, Cham. https://doi.org/10.1007/978-3-031-33537-2_19

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