EWMA 2013 - Ep468 - Corrective treatment of deformities in diabetic foot patients

CORRECTIVE TREATMENT OF DEFORMITIES IN DIABETIC FOOT PATIENTS

Vučetić Č1,2, Borović S4, Delić J3, Jeremić J2,5, Tulić G1,2, Manojlović R1,2,

Ukropina B1, Karović B1, Carević Z1

1Clinic for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, Belgrade, Serbia 2Faculty of Medicine, University of Belgrade, Serbia 3City Institute for Skin and Venreal Diseases. Belgrade, Serbia 4Institute for Cardiovascular Diseases 'Dedinje’ Belgrade, Serbia 5Clinic for Plastic Surgery, Clinical Centre of Serbia, Belgrade, Serbia

EWMA 2013. maj 15-17, Copenhagen

Electronic poster EP 468 Diabetic foot

mail: cedomir [email protected]

Introduction:

• Foot deformities are often suitable for ulcer appearance at diabetic foot (DF) and this is the reason why corrective treatment of foot deformities has great importance in ulcer prevention and also in ulcer healing.

• Corrective treatment can be: - non operative and

- surgical.

• Non operative treatment can be useful at:

- starting stages of foot deformities and

- also has great adventages at neuropathic joint (Scharcot).

• Surgical treatment is needed in cases of obvious changes on the frontal part of the foot.

EWMA 2013. maj 15-17, Copenhagen. E poster EP 468 Diabetic foot

Aim:

This work is a review of surgical treatment of foot deformities in diabetes

EWMA 2013. maj 15-17, Copenhagen. E poster EP 468 Diabetic foot

Ulceration dig. II Displacement art. PIP Resection art . 3 weeks after oper.

Method: Diabetic patients with deformities on the frontal part of the foot, with or without foot ulcers, were treated operatively. The patients were selected: - by clinical examination and - by radiographical examination for operative treatment.

Contraindications for deformity treatment are :

- circulation insufficiency

- infections and

- gangrena.

EWMA 2013. maj 15-17, Copenhagen. E poster EP 468 Diabetic foot

Digitus flexus dig.II and ulceration post resectio art PIP and fixatio

Results:

• 26 patients with 27 deformities were treated operatively. There were claw toe (6), hammer toe (6), unguis incarnatus (4), digitus supraductus (2), subluxatio art.IF (6), bunioneta (3).

• There were no infections postoperatively and the operative wound was healed in 12 days average (7-20).

• Deformity correction was achieved and there was an aesthetic and functional improvement.

• The healing of ulceration related to deformity, applied without surgical treatment of deformity itself, can reach only the partial success.

EWMA 2013. maj 15-17, Copenhagen

Woman 34 year. Deformatio pedis. Op. Resection MT III reposition and fixation

Pre op.

Displacement MTP III

Post op.

Post op.

6 week post op.

Conclusion:

• In cases of obvious deformities, with or without ulceration on the frontal part of the foot, operative treatment is recommended and good results are expected.

EWMA 2013. maj 15-17, Copenhagen

3 years of ulceration Post op. exciso, fixatio 1 week post op.