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One-stage hindfoot debridement and arthrodesis improved pain and function in 21 patients with chronic infectionsCan a single surgery finally stop chronic foot infections and restore your mobility?

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Key Takeaway
Consider one-stage debridement and arthrodesis for chronic hindfoot infections, noting limited evidence from a small retrospective cohort.

This retrospective study examined 21 patients diagnosed with chronic hindfoot infections. The intervention involved a one-stage procedure combining debridement with arthrodesis utilizing external fixators. Patients underwent either arthroscopic debridement (n=9) or combined open debridement (n=12). Arthrodesis types included tibiotalar (n=6), tibiotalocalcaneal (n=14), and pan-tarsal (n=1) procedures.

Primary outcomes assessed pain via Visual Analog Scale (VAS) and joint function using the American Orthopaedic Foot & Ankle Society (AOFAS) score, alongside infection recurrence and osseous consolidation. Pain (VAS) demonstrated significant improvement, decreasing from a mean of 6.4 ± 1.7 preoperatively to 1.3 ± 1.4 postoperatively (p < 0.05). Joint function (AOFAS) also showed improvement, shifting from a preoperative mean of 40.0 ± 11.6, although the specific postoperative mean value was not fully reported in the source data.

No adverse events, serious adverse events, discontinuations, or specific tolerability issues were reported. The mean follow-up duration was 38.2 months, ranging from 25 to 103 months. However, the study design is observational and lacks a comparator group. The small sample size of 21 patients limits statistical power and the ability to draw broad conclusions. Consequently, the clinical relevance of these results for standard practice remains uncertain without further validation in larger, controlled cohorts.

Imagine living with a chronic infection in the back of your foot. It hurts, limits your movement, and refuses to go away. A new look at 21 patients with these stubborn hindfoot infections shows what happened when doctors used a one-stage procedure. This approach involved cleaning out the infection, fusing the joint, and using an external fixator to hold everything in place while it healed.

The results were promising for these specific patients. Their pain scores dropped sharply from an average of 6.4 down to 1.3. Joint function also improved, though the exact final score wasn't fully reported in the data. The team used different types of joint fusions and cleaning methods, but the main takeaway is that this specific surgical plan helped people feel better.

It is important to remember that this study looked back at past records rather than following a strict plan forward. With only 21 people involved, the findings are a starting point, not a final answer. No serious safety issues were reported in this small group, but we must wait for larger studies to confirm if this works for everyone before changing how doctors treat these difficult infections.

What this means for you:
A one-stage surgery helped 21 patients with chronic foot infections feel less pain and move better, but larger studies are needed first.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundChronic 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.MethodsFrom 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.ResultsThe tibiotalar, tibiotalocalcaneal, and pan-tarsal arthrodesis were performed in 6, 14 and 1 patients, respectively. The surgical debridement procedures were performed using arthroscopic (n = 9) and combined open (n = 12) methods. The mean follow-up duration was 38.2 (range 25–103) months. The procedure achieved significant pain relieve and functional improvement, as evidenced by the substantial improvement in VAS and AOFAS score from 6.4 ± 1.7 and 40.0 ± 11.6 preoperatively to 1.3 ± 1.4 (p 
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