{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:07:49Z","timestamp":1775797669469,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic hindfoot infections poses a significant threat to limb integrity and quality of life. The one-stage procedure, involving implants removal, debridement, and simultaneous arthrodesis, may serve as an alternative choice. The present retrospective study aimed to assess the efficacy of the one-stage procedure using external fixators for the treatment of chronic hindfoot infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From April 2016 to December 2022, 21 patients with chronic hindfoot infections underwent one-stage procedure with debridement and arthrodesis using external fixators. Pain and joint function were evaluated using the Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Score. Infection recurrence and osseous consolidation were appraised using the Musculoskeletal Infection Society criteria and radiological examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The tibiotalar, tibiotalocalcaneal, and pan-tarsal arthrodesis were performed in 6, 14 and 1 patients, respectively. The surgical debridement procedures were performed using arthroscopic (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099) and combined open (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) methods. The mean follow-up duration was 38.2 (range 25\u2013103) months. The procedure achieved significant pain relieve and functional improvement, as evidenced by the substantial improvement in VAS and AOFAS score from 6.4\u2009\u00b1\u20091.7 and 40.0\u2009\u00b1\u200911.6 preoperatively to 1.3\u2009\u00b1\u20091.4 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and 78.4\u2009\u00b1\u200910.8 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) postoperatively, respectively. No instance of infection recurrence was observed during follow-up, and successful osseous consolidation was achieved in 20 patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The one-stage procedure with debridement and arthrodesis using external fixators represented an alternative method for the treatment of chronic hindfoot infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1787590","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:26:32Z","timestamp":1775795192000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["One-stage procedure with debridement and arthrodesis using external fixators for the treatment of chronic hindfoot infections: a retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Ying","family":"Li","sequence":"first","affiliation":[{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, The Fourth Clinical College of Peking University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, The Fourth Clinical College of Peking University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, The Fourth Clinical College of Peking University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baozhou","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, The Fourth Clinical College of Peking University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, The Fourth Clinical College of Peking University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Department of Foot and Ankle Surgery, Beijing JiShuiTan Hospital, The Fourth Clinical College of Peking University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1016\/S0140-6736(09)61595-6","article-title":"Bacterial septic arthritis in adults","volume":"375","author":"Mathews","year":"2010","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.2106\/JBJS.RVW.18.00080","article-title":"Septic arthritis of the native ankle","volume":"7","author":"Movassaghi","year":"2019","journal-title":"JBJS Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3113\/FAI.2012.0173","article-title":"Cement spacer as definitive management for postoperative ankle infection","volume":"33","author":"Ferrao","year":"2012","journal-title":"Foot Ankle Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1177\/1071100714563309","article-title":"An analysis of 2 fusion methods for the treatment of osteomyelitis following fractures about the ankle","volume":"36","author":"Moore","year":"2015","journal-title":"Foot Ankle Int"},{"key":"B5","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/S1083-7515(01)00008-0","article-title":"Arthodesis of the infected ankle and subtalar joint","volume":"7","author":"Baumhauer","year":"2002","journal-title":"Foot Ankle Clin"},{"key":"B6","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1053\/j.jfas.2016.10.022","article-title":"Long-term outcomes of permanent cement spacers in the infected foot","volume":"56","author":"Elmarsafi","year":"2017","journal-title":"J Foot Ankle Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0020-1383(00)00156-X","article-title":"Arthrodesis after osteosynthesis and infection of the ankle joint","volume":"32","author":"Hulscher","year":"2001","journal-title":"Injury"},{"key":"B8","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.fas.2012.10.001","article-title":"Versatility of ilizarov technique in difficult cases of ankle arthrodesis and review of literature","volume":"19","author":"Khanfour","year":"2013","journal-title":"Foot Ankle Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.ijsu.2015.04.079","article-title":"ASA class is a reliable independent predictor of medical complications and mortality following surgery","volume":"18","author":"Hackett","year":"2015","journal-title":"Int J Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"70S","DOI":"10.1177\/1071100719861644","article-title":"What is the optimal antibiotic (type, dose and route of administration) treatment for infections after foot\/ankle fracture or fusion procedures?","volume":"40","author":"Pedowitz","year":"2019","journal-title":"Foot Ankle Int"},{"key":"B11","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1177\/107110079902000805","article-title":"Ankle fusion in a high risk population: an assessment of nonunion risk factors","volume":"20","author":"Perlman","year":"1999","journal-title":"Foot Ankle Int"},{"key":"B12","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.cpm.2023.02.007","article-title":"Arthroscopic treatment of the septic ankle","volume":"40","author":"Thompson","year":"2023","journal-title":"Clin Podiatr Med Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"101754","DOI":"10.1016\/j.foot.2020.101754","article-title":"Role of arthroscopy and endoscopy in management of tuberculosis of the foot and ankle","volume":"46","author":"Lui","year":"2021","journal-title":"Foot (Edinb)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1053\/j.jfas.2010.10.011","article-title":"Arthrodesis with internal fixation of the infected ankle","volume":"50","author":"Klouche","year":"2011","journal-title":"J Foot Ankle Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1097\/00005373-199912000-00013","article-title":"Arthrodesis of the infected ankle and subtalar joint: technique, indications, and results of 45 consecutive cases","volume":"47","author":"Richter","year":"1999","journal-title":"J Trauma"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.3113\/FAI.2012.1031","article-title":"Current concepts review: risk factors for nonunions in foot and ankle arthrodeses","volume":"33","author":"Thevendran","year":"2012","journal-title":"Foot Ankle Int"},{"key":"B17","first-page":"160","article-title":"Ilizarov ankle arthrodesis","author":"Johnson","year":"1992","journal-title":"Clin Orthop Relat Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1097\/01.TA.0000051933.83342.E4","article-title":"Fusion of the septic ankle: experience with 15 cases using hybrid external fixation","volume":"55","author":"Kollig","year":"2003","journal-title":"J Trauma"},{"key":"B19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1177\/107110070202300309","article-title":"Revision ankle arthrodesis","volume":"23","author":"Midis","year":"2002","journal-title":"Foot Ankle Int"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.3113\/FAI.2008.1001","article-title":"Tibiocalcaneal arthrodesis using the Ilizarov technique in the presence of bone loss and infection of the talus","volume":"29","author":"Rochman","year":"2008","journal-title":"Foot Ankle Int"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1007\/s00402-016-2520-y","article-title":"Arthrodesis for septic arthritis of the ankle: risk factors and complications","volume":"136","author":"Suda","year":"2016","journal-title":"Arch Orthop Trauma Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.fas.2019.05.001","article-title":"External versus internal fixation for arthrodesis of chronic ankle joint infections\u2014a comparative retrospective study","volume":"26","author":"Ruschenschmidt","year":"2020","journal-title":"Foot Ankle Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2151","DOI":"10.1002\/jor.24938","article-title":"Treatment of hindfoot and ankle infections with Ilizarov external fixator or spacer, followed by secondary arthrodesis","volume":"39","author":"Hartmann","year":"2021","journal-title":"J Orthop Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"139","DOI":"10.26355\/eurrev_201904_17483","article-title":"Arthrodesis of the ankle joint in septic osteoarthritis: six years long term outcomes in authors\u2019 personal experience","volume":"23","author":"Simoni","year":"2019","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1177\/10711007241283803","article-title":"One-stage tibiotalocalcaneal arthrodesis for severe septic destruction of the ankle joint using a retrograde intramedullary nail: a retrospective cross-sectional study","volume":"45","author":"Boucly","year":"2024","journal-title":"Foot Ankle Int"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1787590\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:26:33Z","timestamp":1775795193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1787590\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":25,"alternative-id":["10.3389\/fsurg.2026.1787590"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1787590","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1787590"}}