Singer A
Arch Surg. 1976 Sep;111(9):964-8. doi: 10.1001/archsurg.1976.01360270036006.
Mal perforans is a chronic foot ulcer commonly found in diabetics with neuropathy. Although it will often respond to conservative measures, recurrence is frequent and brings with it the risk of spreading infection and serious destruction of tissues. Surgical treatment of seven patients, based on excision of the distal metatarsal bone (five patients), or excision of the distal metatarsal and amputation of the first toe (two patients), gave satisfactory results and is indicated to achieve long-term healing. A special shoe, designed to remove pressure from the healing areas as well as from potential new pressure points, was used in the last four patients.
穿通性溃疡是糖尿病神经病变患者常见的慢性足部溃疡。尽管它通常对保守治疗有反应，但复发很常见，会带来感染扩散和组织严重破坏的风险。对7例患者进行手术治疗，其中5例切除远端跖骨，2例切除远端跖骨并截除第一趾，结果令人满意，这是实现长期愈合的有效方法。最后4例患者使用了一种特殊的鞋子，这种鞋子旨在消除愈合部位以及潜在新压力点的压力。
