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Related Experiment Videos

Is prophylactic diabetic foot surgery dangerous?

D G Armstrong1, L A Lavery, S Stern

  • 1Department of Orthopaedics University of Texas Health Science Center, San Antonio 78284-7776, USA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|November 1, 1996
PubMed
Summary

Elective foot surgery for toe deformities in diabetics with prior ulcers had a 14.3% infection rate. However, long-term outcomes were good, with 96.3% remaining ulcer-free post-surgery.

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Area of Science:

  • Podiatric surgery
  • Diabetic foot complications
  • Orthopedic surgery

Background:

  • Diabetic foot deformities pose risks for limb-threatening events.
  • Treatment aims to preserve ambulatory function and prevent complications.
  • Isolated toe deformities require careful surgical consideration in diabetic patients.

Purpose of the Study:

  • To compare morbidity and outcomes of elective foot surgery in diabetic and non-diabetic patients with isolated toe deformities.
  • To assess the prevalence of infection, wound complications, and ulcer recurrence.
  • To evaluate the impact of prior ulceration history in diabetic patients undergoing surgery.

Main Methods:

  • Retrospective comparison of 31 diabetic and 33 non-diabetic patients undergoing proximal interphalangeal joint arthroplasty.

Related Experiment Videos

  • Follow-up period of 3 years (mean).
  • Diabetic subgroup analysis based on history of ulceration.

    • Main Results:

    • Diabetics with a history of ulceration had a significantly higher postoperative infection rate (14.3%) compared to those without (0%) and non-diabetics (0%).
    • No significant difference in wound dehiscence rates between diabetic and non-diabetic groups.
    • Excellent long-term outcomes for prophylactic surgery in previously ulcerated sites, with 96.3% remaining ulcer-free.

    Conclusions:

    • Diabetic patients with a history of foot ulcers are at increased risk for postoperative infection after elective toe deformity surgery.
    • Prophylactic surgery for insensate, deformed toes, even with a history of ulceration, can lead to favorable long-term outcomes.
    • Careful patient selection and management are crucial for optimizing surgical outcomes in diabetic foot deformities.