Current concepts in curative surgery for diabetic forefoot ulcers

Area of Science:

• Podiatry
• Diabetology
• Orthopedic Surgery

Background:

• Diabetic forefoot ulcerations are a prevalent complication, significantly impacting patient mobility and quality of life.
• Key risk factors include biomechanical foot deformities and peripheral neuropathy, necessitating effective management strategies.
• Current management emphasizes local wound care, vascular assessment, and offloading, but recurrence is common if deformities persist.

Purpose of the Study:

• To review evidence-based surgical procedures for correcting foot deformities.
• To identify surgical interventions that promote healing of neuropathic forefoot ulcers.
• To provide guidance on surgical management when conservative measures are insufficient.

Main Methods:

• Systematic review of medical literature focusing on surgical interventions for diabetic forefoot ulcers.
• Analysis of studies reporting outcomes of deformity correction in neuropathic feet.
• Evaluation of evidence supporting specific surgical techniques for ulcer healing and recurrence prevention.

Main Results:

• Surgical correction of uncorrectable foot deformities is often required for ulcer healing.
• Various procedures exist to address specific deformities contributing to ulcer recurrence.
• Evidence supports surgical intervention in select cases where conservative offloading fails.

Conclusions:

• Surgical correction of foot deformities is a critical option for intractable neuropathic forefoot ulcers.
• Appropriate surgical techniques can lead to ulcer healing and reduce recurrence rates.
• A multidisciplinary approach integrating surgical expertise is vital for managing complex diabetic foot complications.