Operative treatment of diabetic foot
Hintermann, B.
Praxis 88(27-28): 1191-1195
1999
ISSN/ISBN: 1661-8157 PMID: 10444998 Document Number: 506953
The majority of diabetic foot ulcers are the results of repetitive pressure that exceeds the threshold of soft-tissue tolerance, leading to mechanical destruction of the tissue. Progression of plantar ulcers can rapidly lead to osteomyelitis that may result in loss of the foot through amputation. In order to prevent such a disaster, surgical treatment should be taken into consideration when conservative treatment remains without success. The goal of surgical treatment of an infected ulcer is debridement of the soft-tissue and removal of the underlying pressure by careful bone resection or correction of a deformity by arthrodesis. Various authors have recently reported successful surgical reconstruction of neuroarthropathic foot deformity and instability. Apparently arthrodesis is a viable alternative to amputation for patients with unstable deformity or recurrent ulceration. Proper preoperative evaluation is mandatory. The indications are not well defined yet.