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Updated: Jun 28, 2026

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Orthopaedic care pathway for diabetic foot disease : experience from a UK rural district general hospital

Nijil Vasukutty1, Girish Gopinath1

  • 1Pilgrim Hospital, United Lincolnshire Teaching Hospitals NHS Trust, Boston, UK.

The Bone & Joint Journal
|February 28, 2026
PubMed

Insights

A new orthopaedic care pathway for diabetic foot patients in district general hospitals (DGHs) achieved a 93.4% limb salvage rate. This multidisciplinary approach improved infection resolution and mobility for patients with diabetic foot disease.

Area of Science:

  • Orthopaedic Surgery
  • Diabetic Foot Management
  • Limb Salvage

Background:

  • Diabetic foot disease is a leading cause of non-traumatic lower limb amputations in the UK.
  • Management in district general hospitals (DGHs) is inconsistent compared to tertiary centres.
  • A dedicated orthopaedic pathway aims to standardize care in DGHs.

Purpose of the Study:

  • To describe a dedicated orthopaedic care pathway for diabetic foot patients managed by a multidisciplinary team in a DGH.
  • To evaluate the effectiveness of this pathway in terms of limb salvage and patient outcomes.

Main Methods:

  • Implementation of emergency, urgent, and elective orthopaedic pathways for diabetic foot patients.
  • Management by a multidisciplinary foot team within a DGH setting.
  • Tracking patient pathways, procedures, and outcomes over a defined period.

Main Results:

  • 104 patients managed between August 2019 and September 2023.
  • 93.4% limb salvage rate (85 of 91 patients).
  • 84.6% achieved infection resolution and wound healing; 73% regained independent mobility.

Conclusions:

  • An orthopaedic care pathway managed by a multidisciplinary team can be effectively implemented in a DGH.
  • This approach yields excellent limb salvage rates and acceptable complication rates for diabetic foot disease.
  • Standardized pathways improve outcomes for diabetic foot patients in non-tertiary settings.
Abstract

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