Syme's two-stage amputation in insulin-requiring diabetics with gangrene of the forefoot.
Thirty-five insulin-requiring adult diabetic patients underwent 38 Syme's Two-Stage amputations for gangrene of the forefoot with nonreconstructible peripheral vascular insufficiency. All had a minimum Doppler ischemic index of 0.5, serum albumin of 3.0 gm/dl, and total lymphocyte count of 1500. Thirty-one (81.6%) eventually healed and were uneventfully fit with a prosthesis. Regional anesthesia was used in all of the patients, with 22 spinal and 16 ankle block anesthetics. Twenty-seven (71%) returned to their preamputation level of ambulatory function. Six (16%) had major, and fifteen (39%) minor complications following the first stage surgery. The results of this study support the use of the Syme's Two-Stage amputation in adult diabetic patients with gangrene of the forefoot requiring amputation.
Pinzur
M S
MS
Hines Veterans Administration Hospital, Illinois.
Morrison
C
C
Sage
R
R
Stuck
R
R
Osterman
H
H
Vrbos
L
L
D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D004188:Disarticulation / Q000379:methods / Q000534:rehabilitation; D005360:Fibula / Q000601:surgery; D005545:Forefoot, Human / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D005734:Gangrene; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D013977:Tibia / Q000601:surgery; D014945:Wound Healing