FUNCTIONAL OUTCOME AND COMPLICATIONS OF PARTIAL FOOT AMPUTATIONS IN DIABETICS

Document Type : Original Article

Authors

1 Departments of General Surgery, Faculty of Medicine, Beni-Suef University

2 Critical Care Medicine, Faculty of Medicine, Cairo University

3 Rehabilitation, 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.

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