{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:44:10Z","timestamp":1791312250700,"version":"4.3.1"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Very few studies reported outcomes of common conservative surgeries with antibiotic-impregnated cement when treating diabetic foot osteomyelitis (DFO). The aim of this descriptive study is to report the results of the association of cement with a specific type of toe-sparing resection, combining total metatarsectomy\/phalangectomy (internal pedal amputation) with partial bone excision, for acute on chronic forefoot DFO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Six patients with confirmed acute on chronic DFO were included. A probe-to-bone test was performed for open wounds. For all patients, radiographs, magnetic resonance imaging (MRI), and pathology were conducted in search of osteomyelitis signs. The level of resection was defined as 1\u2009cm away from the contrast enhancement shown on MRI. The polymethylmethacrylate (PMMA) cement was prepared with 2\u2009g of vancomycin before being placed in the defect. A minimum period of 6\u2009months of clinical follow-up was set.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All patients demonstrated wound healing at last follow-up with normalized C-reactive protein. There were no clinical signs of osteomyelitis recurrence. One wound infection was recorded 4\u2009weeks postoperatively and treated successfully with debridement and lavage. None of the cement had to be removed or exchanged. Subjectively, 5 patients were extremely satisfied scoring 5\/5 on Likert scale, and 1 patient was moderately satisfied (3\/5). All patients were able to walk with full weight using insoles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This preliminary report demonstrated that PMMA cement could be a viable option when used to locally control infection following an internal pedal amputation for acute on chronic DFO of the toes. In addition to the high rate of healing, the esthetical result was highly appreciated by the patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114251394009","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:40:08Z","timestamp":1763444408000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute on Chronic Diabetic Forefoot Osteomyelitis Treated With Internal Pedal Amputation and Cement: A Preliminary Report"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-9892","authenticated-orcid":false,"given":"Kaissar","family":"Yammine","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon"},{"name":"Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon"},{"name":"Center for Evidence-Based Anatomy, Sport &amp; Orthopedics Research, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Mouawad","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Jamaleddine","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chahine","family":"Assi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-1131-8"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734610361949"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-19940501-12"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2014.08.004"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1214163"},{"issue":"3","key":"e_1_3_3_7_2","first-page":"20","article-title":"Location of lower-extremity diabetic foot ulcers with concomitant arterial or venous disease","volume":"11","author":"Ellis S","year":"2020","unstructured":"Ellis S, Patel M, Koschak E, Lantis JII. Location of lower-extremity diabetic foot ulcers with concomitant arterial or venous disease. Wounds Int. 2020;11(3):20-23.","journal-title":"Wounds Int"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2016.10.022"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.04.089"},{"key":"e_1_3_3_10_2","article-title":"Diagnosing and treating diabetic foot infections","volume":"20","author":"Lipsky BA","year":"2004","unstructured":"Lipsky BA, Berendt AR, Embil J, De Lalla F. Diagnosing and treating diabetic foot infections. Diabetes Metab Res Rev. 2004;20(suppl 1):S56-S64.","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0213"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-D-19-00099"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2016.10.013"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007760050117"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2009.06.010"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679808997790"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2020.04.025"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640019857795"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.19.00162"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734619888361"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2021.03.008"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.07.086"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2024.01.001"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/19386400241274624"}],"container-title":["Foot &amp; Ankle Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114251394009","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24730114251394009","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114251394009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:24:42Z","timestamp":1777411482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24730114251394009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/24730114251394009"],"URL":"https:\/\/doi.org\/10.1177\/24730114251394009","relation":{},"ISSN":["2473-0114","2473-0114"],"issn-type":[{"value":"2473-0114","type":"print"},{"value":"2473-0114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"article-number":"24730114251394009"}}