Efficacy of Fifth Metatarsal Head Resection for Treatment of Chronic Diabetic Foot Ulceration

2005 ◽  
Vol 95 (4) ◽  
pp. 353-356 ◽  
Author(s):  
David G. Armstrong ◽  
Mark A. Rosales ◽  
Agim Gashi

This study compares the potential benefit of fifth metatarsal head resection versus standard conservative treatment of plantar ulcerations in people with diabetes mellitus. Using a retrospective cohort model, we abstracted data from 40 patients (22 cases and 18 controls) treated for uninfected, nonischemic diabetic foot wounds beneath the fifth metatarsal head. There were no significant differences in sex, age, duration of diabetes mellitus, or degree of glucose control between cases and controls. Patients who underwent a fifth metatarsal head resection healed significantly faster (mean ± SD, 5.8 ± 2.9 versus 8.7 ± 4.3 weeks). Patients were much less likely to reulcerate during the period of evaluation in the surgical group (4.5% versus 27.8%). The results of this study suggest that fifth metatarsal head resection is a potentially effective treatment in patients at high risk of ulceration and reulceration. (J Am Podiatr Med Assoc 95(4): 353–356, 2005)

2020 ◽  
Vol 21 (Issue 1 Volume 21, 2020) ◽  
pp. 33-40
Author(s):  
Letizia Pieruzzi ◽  
Elisabetta Iacopi ◽  
Maria Grazia Buccarello ◽  
Ludovica Tamburini ◽  
Chiara Goretti ◽  
...  

Diabetic foot ulceration (DFU) is a severe complication of diabetes mellitus associated with a high morbidity and mortality rate, whose treatment requires considerable financial costs. This paper describes a test of the efficacy of proactive screening – autonomously managed by nurses in a community setting – in detecting patients at high risk of DFU, as an integrated part of a chronic care model strategy.


2000 ◽  
Vol 11 (suppl d) ◽  
pp. 15D-21D
Author(s):  
Gordon Dow ◽  
The Diabetic Foot Care Plan Working Group

Diabetes mellitus is the number one cause of limb loss in North America, and is associated with growing, unacceptable rates of morbidity, mortality and economic loss. Approximately 80% of these amputations are preceded by the development of foot ulceration. Various disciplines have studied the prevention and management of foot ulceration in those with diabetes. The present care plan was constructed to incorporate the important contributions from these disciplines into practical therapeutic guidelines. The care plan has been divided into three basic sections: assessment, general management and antibiotic therapy. Each of these sections is described in detail and borrows heavily from previous Canadian position papers. Application of the care plan is illustrated by multiple diabetic foot clinical scenarios, which have been categorized according to the Wagner classification.


2010 ◽  
Vol 100 (5) ◽  
pp. 369-384 ◽  
Author(s):  
Robert G. Frykberg ◽  
Nicholas J. Bevilacqua ◽  
Geoffrey Habershaw

Surgical intervention for chronic deformities and ulcerations has become an important component in the management of patients with diabetes mellitus. Such patients are no longer relegated to wearing cumbersome braces or footwear for deformities that might otherwise be easily corrected. Although surgical intervention in these often high-risk individuals is not without risk, the outcomes are fairly predictable when patients are properly selected and evaluated. In this brief review, we discuss the rationale and indications for diabetic foot surgery, focusing on the surgical decompression of deformities that frequently lead to foot ulcers. (J Am Podiatr Med Assoc 100(5): 369–384, 2010)


2010 ◽  
Vol 13 (4) ◽  
pp. 63-68 ◽  
Author(s):  
Alla Yur'evna Tokmakova ◽  
Lyudmila Petrovna Doronina ◽  
Galina Yur'evna Strakhova

Current trends in conservative therapy of chronic wounds associated with diabetes mellitus are discussed along with results of original studies aimedto assess efficacy of different methods for unloading the affected leg in patients with the neuropathic form of diabetic foot syndrome and diabeticnephropathy. Effects of collagen-containing dressings on the wound-related factors (matrix metalloproteinases 2 and 9, collagenolytic activity) andwound epithelization rate are described.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Hígor Chagas Cardoso ◽  
Ana Laura de Sene Amâncio Zara ◽  
Suélia de Siqueira Rodrigues Fleury Rosa ◽  
Gabriel Alves Rocha ◽  
João Victor Costa Rocha ◽  
...  

Background. An individual with diabetes mellitus (DM) has an approximately 25% risk of developing ulcerations and/or destruction of the feet’s soft tissues. These wounds represent approximately 20% of all causes of hospitalizations due to DM. Objective. To identify the factors for the development of diabetic foot ulceration (DFU) among individuals treated by the Brazilian public health system. Methods. This cross-sectional study was conducted on individuals with diabetes mellitus, aged above 18 years, of both sexes, and during July-October 2018 within a public healthcare unit in Brazil. All participants were assessed based on their socioeconomic, behavioral, and clinical characteristics, along with vascular and neurological evaluations. All participants were also classified according to the classification of risk of developing DFU, in accordance with the International Working Group on the Diabetic Foot (IWGDF). Statistical analyses were conducted using the chi-squared test, chi-squared test for trend, and Fisher’s exact test, with a significance level of 5% (p<0.05). Results. The study consisted of 85 individuals. The DFU condition was prevalent in 10.6% of the participants. Adopting the classification proposed by IWGDF, observed risks for stratification categories 0, 1, 2, and 3 were 28.2%, 29.4%, 23.5%, and 8.2%, respectively. A statistically significant (p<0.05) association was observed between the development of DFU and the following variables: time since the diagnosis of diabetes and the appearance of the nails, humidity, and deformations on the feet. Conclusion. The present study found an elevated predominance of DM patients in the Brazilian public health system (SUS) featuring cutaneous alterations that may lead to ulcers; these individuals had elevated risks of developing DFU. Furthermore, it was revealed that the feet of patients were not physically examined during treatment.


2007 ◽  
Vol 120 (12) ◽  
pp. 1042-1046 ◽  
Author(s):  
David G. Armstrong ◽  
Katherine Holtz-Neiderer ◽  
Christopher Wendel ◽  
M. Jane Mohler ◽  
Heather R. Kimbriel ◽  
...  

2003 ◽  
Vol 20 (3) ◽  
pp. 247-248 ◽  
Author(s):  
D. G. Armstrong ◽  
C. Dang ◽  
B. P. Nixon ◽  
A. J. M. Boulton

Masker Medika ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 163-175
Author(s):  
Sukron Sukron

Latar Belakang : Meningkatnya angka penyakit diabetes melitus tipe 2 khususnya di Indonesia bersamaan dengan meningkatnya komplikasi salah satunya diabetic foot ulcer yang juga merupakan faktor terjadinya gangguan sensitivitas pada kaki. Pencegahan dapat dilakukan dengan mengukur sensitivitas kaki dengan menggunkan monofilmen test. Tujuan Penelitian : Untuk mengetahui gambaran tingkat sensitivitas kaki pada penderita diabetes melitus tipe 2 di Rumah Sakit Muhammadiyah Palembang. Metode Penelitian : Penelitian ini merupakan penelitian dengan metode Deskripti Analitik dengan pendekatan kuantitatif. Teknik sampling menggunakan convenience sampling pada pasien diabetes melitus tipe 2 di Rumah Sakit Muhammadiyah Palembang yang berjumlah 60 responden. Hasil : Hasil penelitian menunjukkan bahwa rata-rata pasien diabetes melitus tipe 2 berusia 59,45 tahun dan sebagaian besar berjenis kelamin laki-laki dengan tingkat pendidikan sebesar 33,3% SD dan 33,3% SMA. Rerata responden juga menderita diabetes melitus tipe 2 selama 3,58 tahun dengan sebagian besar responden tidak berkerja dan tidak berolahraga. Serta tingkat sensitivitas kaki pada pasien diabetes melitus tipe 2yang tidak ada rasa dengan frekuensi tertinggi yaitu pada dorsal kaki sebanyak 25 orang (41,67%), metatarsal head ke-1 sebanyak 23 orang (38,33%), Midfoot bagian Medial sebanyak 22 orang (36,67), jari tengah sebnayk 21 orang (35%), metatarsal head ke-3 sebanyak 20 orang (33,33%), Midfoot bagian lateral sebanyak 20 orang (33,33%), Tumit sebanyak 18 orang (30%), jari kelingking sebanyak 18 orang (30%), metatarsal haed ke-2 sebanyak 17 orang (28,33%), dan terendah yaitu padajempol kaki dengan frekuensi 12 responden (20%). Kesimpulan : sensitivitas kaki pada pasien diabetes melitus tipe II yaitu terendah pada dorsal kaki.   Background: The increasing number of type II diabetes mellitus, especially in Indonesia together with the increase in complications, one of which is diabetic foot ulcer, which is also a factor in sensitivity to the feet. Prevention can be done by measuring foot sensitivity by using a monofilment test. Objective: To find out the description of the level of sensitivity of the foot in patients with type II diabetes mellitus patients in Muhammadiyah Hospital Palembang. Method of Researvh: This research is a research with Analytic Descriptive method with quantitative approach. The sampling technique uses convenience sampling in patients with type II diabetes mellitus at Muhammadiyah Hospital Palembang, amounting to 60 respondents. Result of Research: The results showed that the average type II diabetes mellitus patients were 59.45 years old and most were male with education level of 33.3% elementary school and 33.3% high school. The average respondent also suffered from type II diabetes mellitus for 3.58 years with most respondents not working and not exercising. And the level of sensitivity of the foot in patients with type II diabetes mellitus that does not have the highest frequency is the dorsal foot of 25 people (41.67%), the first metatarsal head of 23 people (38.33%), Midfoot of the Medial section of 22 people (36.67), middle fingers 21 people (35%), 3rd metatarsal head as many as 20 people (33.33%), lateral midfoot as many as 20 people (33.33%), Heel as many as 18 people ( 30%), the pinky finger was 18 people (30%), the second metatarsal haed were 17 people (28.33%), and the lowest was the big toe with a frequency of 12 respondents (20%). Conclusion: Foot sensitivity in type II diabetes mellitus patients is lowest in the dorsal foot.


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