Neuropathic toe ulcers treated with toe flexor tenotomies.
BACKGROUND
Foot ulcers are common causes of hospital admissions for infection and amputation in patients with neuropathy. This retrospective study evaluates the results of treating plantar neuropathic toe ulcers with percutaneous flexor tenotomy.


METHODS
From 1996 to 2003, 28 toe ulcers in 18 patients were treated with tenotomy of the toe flexors.


RESULTS
Fourteen of 18 patients had diabetic neuropathy. No patients were lost to followup. Average followup for the 28 ulcers was 36 (range 20 to 65) months. All ulcers healed. None of the 11 lesser toe ulcers recurred. Three of 17 first toe ulcers recurred but two that had repeat tenotomy healed and did not recur. There were no toe amputations, infections, or other complications of tenotomy. One patient had unrelated transtibial amputation.


CONCLUSIONS
No long-term results of treating toe ulcers with toe flexor tenotomy by other authors have been found. Toe flexor tenotomies appear to be effective and safe treatment for neuropathic toe ulcers.
Laborde
J Monroe
JM
Department of Orthopaedic Surgery, Tulane University School of Medicine, 3434 Prytania St., Suite 450, Orthopaedic Associates of New Orleans, New Orleans, LA 70115, USA. monroe@laborde.net
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000209:etiology / Q000601:surgery*; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000150:complications; D012008:Recurrence; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D014034:Toes / Q000601:surgery*; D014945:Wound Healing