Feasibility and Effectiveness of Internal Pedal Amputation of Phalanx or Metatarsal Head in Diabetic Patients with Forefoot Osteomyelitis

Ezio Faglia, Giacomo Clerici, Maurizio Caminiti, Vincenzo Curci, Francesco Somalvico

Research output: Contribution to journalArticlepeer-review

Abstract

From January 2007 to December 2009, 207 diabetic patients were consecutively admitted to our foot center because of osteomyelitis of a phalanx or metatarsal head. The removal of infected bone was performed by internal bone resection in 110 patients (group A) and amputation in 97 patients (46.9%; group B). Dehiscence occurred in 15 patients (13.6%) patients in group A and 10 patients (10.3%) in group B (p = 0.464). A total of 206 patients (99.5%) were followed up from January 1, 2007 to December 31, 2011. Ulcer relapse occurred in 12 patients (12.4%) in group A and 18 patients (16.4%) in group B (p = .437). A contralateral ulcer occurred in 10 group A patients (10.3%) and 14 group B patients (12.7%; p = .667). The results of the present study have demonstrated that bone resection with preservation of the soft tissue envelope is feasible in approximately one half of diabetic patients with forefoot osteomyelitis and does not result in any risk of major dehiscence or ulcer recurrence compared with ray or toe amputation.

Original languageEnglish
Pages (from-to)593-598
Number of pages6
JournalJournal of Foot and Ankle Surgery
Volume51
Issue number5
DOIs
Publication statusPublished - Sep 2012

Keywords

  • Dehiscence
  • Diabetic foot
  • Infection
  • Minor amputation
  • Reulceration

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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