Tamir Eran, Smorgick Yossi, Ron Guy Zvi, Gilat Ron, Agar Gabriel, Finestone Aharon S
Shamir Medical Center, Zerifin, Israel.
Tel Aviv University, Tel Aviv, Israel.
Int J Low Extrem Wounds. 2022 Jun;21(2):131-136. doi: 10.1177/1534734620934579. Epub 2020 Jun 19.
Diabetic foot ulcers under the first metatarsal head are difficult to treat and prevent recurrence. The aim of this study is to summarize the results of a distal first metatarsal minimally invasive floating osteotomy for ulcers under the first metatarsal head in patients with diabetic neuropathy. We reviewed files of patients with diabetic neuropathy undergoing a floating first metatarsal osteotomy. Demographic and clinical data were collected and analyzed to determine success and complications. We found records for 21 patients (mean age 64) with University of Texas 1A ulcers. The ulcer's mean age was 11.2 months. Following surgery, the ulcer completely resolved after a mean of 3.7 (2 to 11) weeks in 19 patients. During the first year, there were 4 complications related to the surgery (including 3 infections). At latest follow-up, 17/21 (81%) patients had healed with satisfactory results. Minimal invasive floating distal osteotomy of the first metatarsal can cure and prevent recurrence of diabetic foot ulcers under the first metatarsal head in 80% of the patients, but the ability to provide close follow-up and prompt response are prerequisites.
第一跖骨头下的糖尿病足溃疡难以治疗且易复发。本研究旨在总结对患有糖尿病神经病变的患者，采用第一跖骨远端微创浮动截骨术治疗第一跖骨头下溃疡的结果。我们回顾了接受第一跖骨浮动截骨术的糖尿病神经病变患者的病历。收集并分析人口统计学和临床数据，以确定手术的成功率和并发症情况。我们找到了21例（平均年龄64岁）患有德克萨斯大学1A期溃疡的患者记录。溃疡的平均病程为11.2个月。术后，19例患者的溃疡在平均3.7（2至11）周后完全愈合。在第一年，有4例与手术相关的并发症（包括3例感染）。在最近一次随访时，21例患者中有17例（81%）愈合，结果令人满意。第一跖骨远端微创浮动截骨术可使80%的患者治愈并预防第一跖骨头下糖尿病足溃疡的复发，但密切随访和及时应对的能力是前提条件。
