Laborde J Monroe
Department of Orthopaedic Surgery, Tulane University School of Medicine, 3434 Prytania St., Suite 450, Orthopaedic Associates of New Orleans, New Orleans, LA 70115, USA.
Foot Ankle Int. 2007 Nov;28(11):1160-4. doi: 10.3113/FAI.2007.1160.
Foot ulcers are common causes of hospital admissions for infection and amputation in patients with neuropathy. This retrospective study evaluates the results of treating plantar neuropathic toe ulcers with percutaneous flexor tenotomy.
From 1996 to 2003, 28 toe ulcers in 18 patients were treated with tenotomy of the toe flexors.
Fourteen of 18 patients had diabetic neuropathy. No patients were lost to followup. Average followup for the 28 ulcers was 36 (range 20 to 65) months. All ulcers healed. None of the 11 lesser toe ulcers recurred. Three of 17 first toe ulcers recurred but two that had repeat tenotomy healed and did not recur. There were no toe amputations, infections, or other complications of tenotomy. One patient had unrelated transtibial amputation.
No long-term results of treating toe ulcers with toe flexor tenotomy by other authors have been found. Toe flexor tenotomies appear to be effective and safe treatment for neuropathic toe ulcers.
足部溃疡是神经病变患者因感染和截肢而住院的常见原因。这项回顾性研究评估了经皮屈肌切断术治疗足底神经性趾溃疡的效果。
1996年至2003年，对18例患者的28个趾溃疡进行了趾屈肌切断术治疗。
18例患者中有14例患有糖尿病性神经病变。无患者失访。28个溃疡的平均随访时间为36（范围20至65）个月。所有溃疡均愈合。11个小趾溃疡均未复发。17个拇趾溃疡中有3个复发，但其中2个接受重复屈肌切断术的溃疡愈合且未复发。未发生趾截肢、感染或屈肌切断术的其他并发症。1例患者进行了与屈肌切断术无关的经胫骨截肢术。
未发现其他作者采用屈肌切断术治疗趾溃疡的长期结果。屈肌切断术似乎是治疗神经性趾溃疡的有效且安全的方法。
