title: Options for diabetic patients with chronic heel ulcers.
abstract: The presence of a heel ulcer in the diabetic patient is usually due to neuropathy, vasculopathy, or both. Diagnostic testing including noninvasive assessment by nerve conduction velocity and Doppler pressure measurements can provide the basis for subsequent treatment. The diagnosis of osteomyelitis is assisted by plain radiographs, isotope definition, and/or magnetic resonance imaging (MRI). The loss of the calcaneus may mean loss of the functioning foot. Reconstructive arterial surgery for heel lesions in the diabetic patient has limited success. Prevention and local wound care, along with patient education, will result in limb salvage and the prevention of disability.
authors.affiliation: Department of Surgery, Medical College of Pennsylvania/Hahnemann University Hospital/Allegheny University of the Health Sciences, Philadelphia 19102-1192, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Cevera
authors.forename: L L
authors.initials: LL
authors.lastname: Bolton
authors.forename: M D
authors.initials: MD
authors.lastname: Kerstein
mesh_terms: D003925:Diabetic Angiopathies / Q000150:complications* / Q000175:diagnosis; D017719:Diabetic Foot / Q000517:prevention & control / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D006365:Heel; D006801:Humans