Surgical reconstruction of the diabetic foot: a salvage approach for midfoot collapse.
Between 1985 and 1993, 18 patients representing 21 feet underwent surgical reconstruction for diabetic neuroarthropathy with collapse of the midfoot. Forty-seven percent (10/21) of these feet presented with plantar pressure ulcers. Reconstruction involved reduction and fusion of collapsed joints, using internal fixation to restore foot shape and improve weightbearing alignment. The average follow-up in these patients was 28 months (range, 6-84 months). Limb salvage was obtained in 18 of 21 feet. Average time to radiographic union was 5 months (range, 3-9 months). Improvement in shoe fit and ambulatory status was noted for 13 of the 15 patients who had successful reconstruction. Forty-seven percent of the reviewed cases were without any complication throughout their postoperative course. Seventy percent of the presenting ulcers healed without incident. There were no recurrent midfoot ulcers.
Early
J S
JS
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas 75235-8883, USA.
Hansen
S T
ST
D000328:Adult; D000368:Aged; D001177:Arthropathy, Neurogenic / Q000601:surgery; D001863:Bone Screws; D017719:Diabetic Foot / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005530:Foot Deformities / Q000601:surgery; D016523:Foot Ulcer / Q000628:therapy; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D012775:Shoes; D013639:Tarsal Bones / Q000601:surgery; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing; D014945:Wound Healing