Background: Along with significant case transmission, hospitalizations, and mortality experienced during the global Sars-CoV-2 (COVID-19) pandemic, there existed a disruption in the delivery of health care across multiple specialties. We studied the effect of the pandemic on inpatients with diabetic foot problems in a level-one trauma center in Central Ohio. Methods: A retrospective chart review of patients necessitating a consultation by the foot and ankle surgery service were reviewed from the first 8 months of 2020. A total of 270 patients met the inclusion criteria and divided into pre-pandemic (n = 120) and pandemic groups (n = 150). Demographics, medical history, severity of current infection, and medical or surgical management were collected and analyzed.Results: The odds of undergoing any level of amputation was 10.8 times higher during the pandemic versus before the pandemic. The risk of major amputations (below-the-knee or higher) likewise increased with an odds ratio of 12.5 among all patients in the foot and ankle service during the pandemic. Of the patients undergoing any amputation, the odds for receiving a major amputation was 3.1 times higher than before the pandemic. Additionally, the severity of infections increased during the pandemic and a larger proportion of the cases were classified as emergent in the pandemic group compared to the pre-pandemic group.Conclusions: The effect of the pandemic on the health-care system has had a deleterious effect on people with diabetes-related foot problems resulting in more severe infections, more emergencies, and necessitating more amputations. When an amputation was performed, the likelihood it was a major amputation also increased.Editor's Note: This Original Article accompanies "Diabetes-Related Amputations: A Pandemic within a Pandemic," by Lee C. Rogers, DPM, Robert J. Snyder, DPM, and Warren S. Joseph, DPM, FIDSA, available at https://doi.org/10.7547/20-248

Advancing traditional didactic teaching with the use of cost-effective 3-D printing can facilitate the visuospatial comprehension of lower-extremity anatomy. The evolution of 3-D printing enhances the clinical skills essential for the interpretation of imaging studies as well as planning for surgical procedures such as external fixation application.

Case:We report a case of a 46-year-old woman who suffered an insertional Achilles tendon rupture secondary to a fall after undergoing retrocalcaneal and Achilles tendon debridements with flexor tendon transfer. Examination revealed posterior ankle pain with insertional Achilles tendon retraction. Treatment options included continued immobilization vs. surgical repair. She underwent Achilles tendon tenodesis to the calcaneus using a combined gastrocsoleus recession and Krackow suture technique.Conclusion:At the 1-year follow-up, examination revealed pain-free return to normal function. In the presence of a ruptured Achilles tendon with retraction, this repair provided sufficient lengthening and fixation of the Achilles tendon complex.

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