[Surgical treatment of diabetic osteoarthropathy, complicated by pyogenic process in the feet].

The data on the results of combined treatment of 540 patients with diabetic osteoarthropathies (DOAP) complicated by pyonecrotic lesions of the feet (PNLF) are presented. The authors classification of these lesions is proposed which considers location and the stage of the disease. Surgical treatment was used in 387 (71.6%) patients. The analysis of the clinical experience in surgical treatment and the results obtained in patients with DOAP and PNLF allouvs to subdivide surgical procedures in the patients in to the following categories: 1) the initial prophylaxis of development of pyonecrotic processes; 2) measures of secondary prophylaxis of the progression of pyonecrotic processes; 3) amputation of the shin and the thigh. As a result of the complex of curative and prophylactic measures, comprizing surgical treatment, the number of favourable results of treatment in patients of the lest group increased by 24%, and the number of unfavourable outcomes decreased by 25%, the mortality rate in the test group lowered 2, 4 times.