Feasibility of foot deformations corrective operations performing in patients with diabetes

Abstract

Objective: To improve methods of early diagnosis of diabetic neuropathy and suggest options for surgical prophylaxis possible purulent and necrotic complications in patients with diabetic foot syndrome. Materials and Methods. The study involved 64 patients with complicated diabetic foot syndrome (DFS). The average age of patients - 61,9 ± 3,8 years, duration of diabetes - 11,47 ± 3,2 years. The patients had neuropathic and mixed forms of DFS, fingers or arched foot deformations with the presence of pressor venous trophic ulcers in the forefoot. Patients were randomized into two groups: the main group - 34 and comparison group - 30 patients. There were representative characteristics for all groups: age, sex, comorbidity and did not differ significantly (P> 0,05). There were no statistically significant difference between the groups of these data (χ2 = 0,05; P = 0,8195). Results. After 6 months of complex treatment the ulcers were healed in more than half of patients in both groups - 19 (63,3%) of patients in the comparison group and 25 (73,5%) of the main group. In 8 (26,7%) patients in the comparison and 7 (20,6%) of the main group positive dynamics was observed, but over a longer period of treatment . After 12 months, the number of patients whose ulcers were completely healed differed significantly by the main group (P = 0,0007; χ2 = 11,41). Also in the main group was only 1 (3,0%) patient with ulcer that was not healed, in contrast to the comparison group - 7 (23,3%) patients (P = 0,0373; χ2 = 4,34). Conclusions. Operations aimed at correction of fingers and feet deformations in combination with standard therapy and unloading of the lower limb, allow improving the results of patients with complicated DFS treatment by reducing the number of relapses.

Keywords

• diabetic foot
• surgery
• treatment outcome