FUNCTIONAL OUTCOME AND COMPLICATIONS OF PARTIAL FOOT AMPUTATIONS IN DIABETICS | ||
| The Egyptian Journal of Surgery | ||
| Volume 26, Issue 3, July 2007, Pages 106-114 PDF (245.82 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2007.372287 | ||
| Authors | ||
| Usama Imam* 1; Ahmed Elsawy2; Alaadin Balbaa3 | ||
| 1Departments of General Surgery, Faculty of Medicine, Beni-Suef University | ||
| 2Critical Care Medicine, Faculty of Medicine, Cairo University | ||
| 3Rehabilitation, Faculty of Physical Therapy, Cairo University | ||
| Abstract | ||
| Aim: This study was conducted to test a protocol for the management of diabetics scheduled for partial foot amputation in a trial to improve the outcome. Methods: 60 patients underwent partial foot amputation with planned osseous resection and soft tissue coverage followed by postoperative pressure offloading between January 2002 and January 2006. Results: Amputations performed were ray in (51.6%), trans-metatarsal in (43.3%), Lisfranc’s in (3.3%), and Chopart’s in (1.7%). Coverage was done by planter flaps in (70%), combined flaps in (13.3%), skin grafts in (5%), and second intention in (11.7%). Complications were failure in (8.3%), adjacent limited arthritis or osteomyelitis in (11.7%), deformities in (15%), and instability in (11.7%). Further interventions were delayed primary closure in (6.7%), skin grafts in (5%), further partial foot amputation in (11.7%), and below knee amputation in (8.3%). The outcome was 53 partial foot amputees (88.3%) able to use their feet for one year without recurrent ulceration. Conclusion: The marked reduction in failure rate from (52%) in literature to (8.3%) with such protocol is encouraging to pay more interest in partial foot amputations as an alternative to higher ones. | ||
| Keywords | ||
| Durable; functioning; foot residuum | ||
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