数字化关节成形术和关节融合术是否对糖尿病足患者的管理有用且安全？

Are Digital Arthroplasty and Arthrodesis Useful and Safe Surgical Techniques for the Management of Patients with Diabetic Foot?

机构信息

At the Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) 28040, Madrid, Spain, Aroa Tardáguila-García, DPM, PhD; Irene Sanz-Corbalán, DPM, PhD; Mateo López-Moral, DPM, PhD; Marta García-Madrid, DPM; Esther García-Morales, DPM, PhD; and José Luis Lázaro-Martínez, DPM, PhD, are Podiatrists. The authors have disclosed no financial relationships related to this article. Submitted July 27, 2021; accepted in revised form September 7, 2021.

出版信息

Adv Skin Wound Care. 2022 Jul 1;35(7):1-6. doi: 10.1097/01.ASW.0000831088.63458.d3.

DOI:10.1097/01.ASW.0000831088.63458.d3

PMID:35723960

Abstract

OBJECTIVE

To analyze and compare the development of short- and long-term complications in patients with diabetic foot after digital arthroplasty or arthrodesis.

METHODS

The authors reviewed patient records from January 2017 to March 2020. Patients were treated by digital arthroplasty or arthrodesis to correct toe deformity (elective or prophylactic surgery), achieve ulcer healing in toes (curative surgery), or manage toe infection (emergent surgery). During 1-year follow-up, researchers registered short- and long-term complications. Researchers analyzed the association between the type of surgery and the development of short- and long-term complications.

RESULTS

Forty-four patients (83.0%) received arthroplasty, and nine (17.0%) received arthrodesis. The mean time to heal from ulcers was 5.2 ± 5.2 weeks. A significant association was observed between arthrodesis and the development of long-term complications (P = .044; odds ratio, 5.1; 95% confidence interval, 0.9-27.2). No differences were observed between type of surgery and short- or long-term complications. Moreover, both short- and long-term complications were related to longer time to heal (respectively, 7.6 ± 6.0 vs 2.1 ± 0.5 weeks, P < .001; and 6.3 ± 6.2 vs 4.2 ± 4.0 weeks, P = .039).

CONCLUSIONS

Digital arthroplasty or arthrodesis are good options for managing patients with diabetic foot who require digital deformity correction to achieve digital ulcer healing or management of diabetic foot infection in phalanges.

摘要

目的

分析比较糖尿病足患者行趾数字化关节成形术或融合术后短期和长期并发症的发展情况。

方法

作者回顾了 2017 年 1 月至 2020 年 3 月的患者病历。患者接受数字化关节成形术或融合术治疗，以矫正趾畸形（选择性或预防性手术）、实现趾溃疡愈合（治疗性手术）或治疗趾感染（急诊手术）。在 1 年随访期间，研究人员记录了短期和长期并发症。研究人员分析了手术类型与短期和长期并发症发展之间的关系。

结果

44 例（83.0%）患者行关节成形术，9 例（17.0%）患者行融合术。溃疡愈合的平均时间为 5.2 ± 5.2 周。融合术与长期并发症的发生存在显著相关性（P =.044；优势比，5.1；95%置信区间，0.9-27.2）。手术类型与短期或长期并发症之间无差异。此外，短期和长期并发症均与愈合时间延长有关（分别为 7.6 ± 6.0 周比 2.1 ± 0.5 周，P <.001；6.3 ± 6.2 周比 4.2 ± 4.0 周，P =.039）。