Busch-Westbroek Tessa E, Mens Marieke A, van Netten Jaap J, Bus Sicco A, Nieuwdorp Max, Stufkens Sjoerd A
Amsterdam UMC, locatie AMC, Amsterdam: Afd. Revalidatiegeneeskunde.
Contact: Tessa E. Busch-Westbroek (
Ned Tijdschr Geneeskd. 2021 Sep 30;165:D6176.
People with diabetes and polyneuropathy often develop foot deformities, resulting in ulcers or pre-ulcerative lesions on the apex of the toes. The Dutch guideline on diabetic foot disease recommends considering a flexor tendon tenotomy to treat a distal toe ulcer, if conservative treatment fails, and to prevent a toe ulcer if a pre-ulcerative lesion is present. To our knowledge, this technique is rarely performed in the Netherlands and if used, performed with a scalpel. Recent studies show that a new, less invasive technique, the needle flexor tenotomy, is relatively safe and effective. The purpose of this procedure is reducing mechanical pressure. However, this has not yet been quantitatively demonstrated. We regularly apply this new surgical technique, including functional assessment by means of dynamic barefoot pressure measurements. We bring this surgical technique and its biomechanical effect to your attention in this article, as an effective and easy to implement intervention.
糖尿病和多发性神经病变患者常出现足部畸形，导致足尖出现溃疡或溃疡前期病变。荷兰糖尿病足病指南建议，如果保守治疗失败，对于远端足趾溃疡可考虑进行屈肌腱切断术来治疗；如果存在溃疡前期病变，则可预防足趾溃疡。据我们所知，该技术在荷兰很少实施，即便实施也是使用手术刀进行。最近的研究表明，一种新的、侵入性较小的技术——针式屈肌腱切断术相对安全有效。该手术的目的是减轻机械压力。然而，这一点尚未得到定量证实。我们经常应用这种新的手术技术，包括通过动态赤足压力测量进行功能评估。在本文中，我们将这种手术技术及其生物力学效应作为一种有效且易于实施的干预措施介绍给大家。
