近端趾骨旋转截骨术治疗拇趾内侧糖尿病溃疡
Proximal Derotation Phalangeal Osteotomy for Medial First Toe Diabetic Ulcer.
作者信息
Palmanovich Ezequiel, Ohana Nissim, Slevin Omer, Tamir Eran, Ilan Small, Segal David, Atzmon Ran
机构信息
Orthopedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel.
Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Indian J Orthop. 2020 Jul 14;55(Suppl 1):97-102. doi: 10.1007/s43465-020-00193-5. eCollection 2021 May.
BACKGROUND
Foot ulcers are a common complication in diabetic patients. Mild callus formation due to a plantar pressure can lead to an ulcer formation with potentially hazardous sequelae. Eliminating the pressure from the ulcer is essential for a proper healing process. Proximal derotation phalangeal osteotomy is a relatively simple procedure that can redistribute the planter pressure points over the hallux.
METHODS
Thirteen patients underwent proximal derotation phalangeal osteotomy to relieve the bony pressure causing an ulcer in the first toe, which was refractory to non-operative treatment. Twelve patients had diabetes type 2 and one had Charcot-Marie-Tooth disease.
RESULTS
Ulcers were completely resolved in all 13 patients in an average time of 4.3 (range 2-8) weeks. Four patients (31%) had mild complications that resolved well. No further surgery was required at 1-year follow-up.
CONCLUSION
Proximal derotation phalangeal osteotomy enabled ulcer healing in refractory cases.
LEVEL OF EVIDENCE
Level III retrospective study.
背景
足部溃疡是糖尿病患者常见的并发症。足底压力导致的轻度胼胝形成可引发溃疡，并可能伴有危险的后遗症。消除溃疡处的压力对于促进愈合过程至关重要。近端趾骨旋转截骨术是一种相对简单的手术，可重新分配拇趾上的足底压力点。
方法
13例患者接受近端趾骨旋转截骨术，以缓解导致第一趾溃疡的骨压力，这些溃疡对非手术治疗无效。12例患者患有2型糖尿病，1例患有夏科-马里-图思病。
结果
所有13例患者的溃疡均完全愈合，平均愈合时间为4.3周（范围2 - 8周）。4例患者（31%）出现轻度并发症，但恢复良好。1年随访时无需进一步手术。
结论
近端趾骨旋转截骨术可使难治性病例的溃疡愈合。
证据水平
III级回顾性研究。
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