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Trends over the past 20 years
•Increased use of bone resections
•Simplifies wound closure
•Improves biomechanics
•Increased use of tendon
lengthening/transfer
•Improves biomechanics
•Decreases ulcer recurrence
•Increased use of the Wound Vac®
•Does not provide definitive closure
•Simplifies wound care
•Provides for less complex
reconstruction
•Increased use of “skilled nursing
facilities” and “home care”
•More cost effective
•More liberal use of external frames
•Immobilize the limb
•Protect the heel
•Look for nerve compression
syndromes
•Tarsal tunnel syndrome