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微创跖骨骨干远端截骨术治疗糖尿病足足底溃疡：1例报告

Minimally-invasive Distal Metatarsal Diaphyseal Osteotomy in the Treatment of Plantar Ulcer in the Diabetic Foot: A Case Report.

作者信息

Moreira Fernando Delmonte, Jambeiro Jorge Eduardo de Schoucair, Cordeiro Neto Antero Tavares, Dourado Roger Carneiro, Padula Eduardo Carrilho, Guedes Alex

机构信息

Grupo de Cirurgia do Pé e Tornozelo, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil.

Serviço de Pé e Tornozelo, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Dec 27;59(Suppl 2):e228-e232. doi: 10.1055/s-0044-1790194. eCollection 2024 Nov.

DOI:10.1055/s-0044-1790194
PMID:39735448
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11679632/
Abstract

The diabetic foot consumes a large number of resources and has a profound negative impact on quality of life, representing the major non-traumatic cause of lower limb amputation in adults. The present report describes a diabetic patient with a recurrent plantar ulcer in the topography of the heads of the second, third, and fourth metatarsals. The patient was treated using the distal metatarsal diaphyseal osteotomy (DMDO) technique in these bones, an Akin-type percutaneous osteotomy in the proximal phalanx of the hallux, and debridement. The 5-year postoperative follow-up revealed good outcomes regarding healing and prevention of new episodes.

摘要

糖尿病足消耗大量资源，对生活质量产生深远负面影响，是成人下肢非创伤性截肢的主要原因。本报告描述了一名糖尿病患者，其第二、第三和第四跖骨头部位反复出现足底溃疡。对该患者采用了这些骨骼的远端跖骨干截骨术（DMDO）技术、拇趾近节趾骨的Akin型经皮截骨术以及清创术进行治疗。术后5年随访显示，在愈合和预防新发病例方面取得了良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/5972cf66161d/10-1055-s-0044-1790194-i2300174pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/8a97026e1e3b/10-1055-s-0044-1790194-i2300174en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/ef682b98631f/10-1055-s-0044-1790194-i2300174en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/f48ca476ef80/10-1055-s-0044-1790194-i2300174en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/148e436cc561/10-1055-s-0044-1790194-i2300174en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/f06ec0c6ee2b/10-1055-s-0044-1790194-i2300174pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/796e02d73a7e/10-1055-s-0044-1790194-i2300174pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/a2838e4bcbd0/10-1055-s-0044-1790194-i2300174pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/5972cf66161d/10-1055-s-0044-1790194-i2300174pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/8a97026e1e3b/10-1055-s-0044-1790194-i2300174en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/ef682b98631f/10-1055-s-0044-1790194-i2300174en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/f48ca476ef80/10-1055-s-0044-1790194-i2300174en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/148e436cc561/10-1055-s-0044-1790194-i2300174en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/f06ec0c6ee2b/10-1055-s-0044-1790194-i2300174pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/796e02d73a7e/10-1055-s-0044-1790194-i2300174pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/a2838e4bcbd0/10-1055-s-0044-1790194-i2300174pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11679632/5972cf66161d/10-1055-s-0044-1790194-i2300174pt-4.jpg

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本文引用的文献

1
Diabetic Foot. Part 1: Ulcers and Infections.糖尿病足。第1部分：溃疡与感染。
Rev Bras Ortop (Sao Paulo). 2020 Aug;55(4):389-396. doi: 10.1055/s-0039-3402462. Epub 2020 Apr 27.
2
Minimally Invasive Surgery: Osteotomies for Diabetic Foot Disease.微创外科：糖尿病足病的截骨术。
Foot Ankle Clin. 2020 Sep;25(3):441-460. doi: 10.1016/j.fcl.2020.05.006. Epub 2020 Jul 9.
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[Treatment of plantar, neuropathic and metatarsal ulcers by minimally invasive metatarsal osteotomy].[微创跖骨截骨术治疗足底、神经性和跖骨溃疡]
Orthopade. 2020 Jul;49(7):625-631. doi: 10.1007/s00132-019-03848-w.
4
Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (DMDO) for Chronic Plantar Diabetic Foot Ulcers.微创跖骨远端骨干截骨术（DMDO）治疗慢性糖尿病足底溃疡
Foot Ankle Int. 2018 Jan;39(1):83-92. doi: 10.1177/1071100717735640. Epub 2017 Nov 7.
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