Batista Fábio, Magalhães Antonio Augusto, Nery Caio, Baumfeld Daniel, Monteiro Augusto César, Batista Fabíola
Department of Orthopedics and Traumatology, Federal University of São Paulo, Brazil.
Diabet Foot Ankle. 2011;2. doi: 10.3402/dfa.v2i0.10358. Epub 2011 Nov 25.
Complications of diabetes mellitus constitute the most common indications for hospitalization and non-traumatic amputations in the USA. The most important risk factors for the development of diabetic foot ulcerations include the presence of peripheral neuropathy, vasculopathy, limited joint mobility, and pre-existing foot deformities. In our study, 500 diabetic patients treated for plantar forefoot ulcerations were enrolled in a prospective study from 2000 to 2008 at the Federal University of São Paulo, Brazil. Fifty-two patients in the study met the criteria and underwent surgical treatment consisting of percutaneous Achilles tendon lengthening to treat plantar forefoot ulcerations. The postoperative follow-up demonstrated prevention of recurrent foot ulcerations in 92% of these diabetic patients that maintained an improved foot function. In conclusion, our study supports that identification and treatment of ankle equinus in the diabetic population may potentially lead to decreased patient morbidity, including reduced risk for both reulceration, and potential lower extremity amputation.
糖尿病并发症是美国住院治疗和非创伤性截肢最常见的指征。糖尿病足溃疡形成的最重要风险因素包括周围神经病变、血管病变、关节活动受限以及足部既往畸形。在我们的研究中，2000年至2008年期间，500例因足底前足溃疡接受治疗的糖尿病患者在巴西圣保罗联邦大学参与了一项前瞻性研究。研究中有52例患者符合标准并接受了手术治疗，手术包括经皮跟腱延长术以治疗足底前足溃疡。术后随访显示，这些糖尿病患者中有92%预防了足部溃疡复发，足部功能得到改善。总之，我们的研究支持，识别并治疗糖尿病患者的马蹄足可能会降低患者发病率，包括降低再次溃疡和下肢截肢的风险。
