Safety and effectiveness of flexor tenotomies to heal toe ulcers in persons with diabetes.
OBJECTIVE
To evaluate the effectiveness and safety of percutaneous tenotomy of the flexor digitorum longus to heal neuropathic ulcers on the tip of the toe.


METHODS
We retrospectively reviewed a cohort of 48 patients with 58 tenotomy procedures with diabetes related neuropathy and ulceration at the tip of the toe. Subjects were treated with tenotomy of the flexor digitorum longus. We then evaluated healing of the ulceration and any adverse events including recurrence, infection, healing failure, and amputation.


RESULTS
98.3% of the ulcerations healed. Mean ulcer healing time was 40+/-52 days. 12.1% had a recurrence of ulceration at the same site. Mean time to recurrence was 13.9 months. Five percent had post-operative soft tissue infection. Two patients had amputation of the digit; both had pre-existing osteomyelitis. Mean follow up was 28 months.


CONCLUSIONS
Flexor tenotomy is a safe, simple procedure, which can enhance patients' healing potential with very little risk.
Kearney
Tyler P
TP
Department of Surgery, Scott & White Memorial Hospital, Texas A&M Health Science Center, College of Medicine, 600 South 25th Street, Temple, TX 76504, United States. tkearney@swmail.sw.org
Hunt
Nathan A
NA
Lavery
Lawrence A
LA
D000368:Aged; D017719:Diabetic Foot / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014034:Toes / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome