Influence of Hallux Rigidus on Reamputation in Patients With Diabetes Mellitus After Partial Hallux Amputation

Oliver, Noah G.; Attinger, Christopher E.; Steinberg, John S.; Evans, Karen K.; Vieweger, David; Kim, Paul J.

doi:10.1053/j.jfas.2015.06.007

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…One hundred eighty‐two full‐text articles were assessed for eligibility, and 133 (65 reviews, eight studies of duplicated population, and 60 studies with data that cannot be extracted) of them were removed since they did not meet our selection criteria. Finally, 49 articles were included in our meta‐analysis after full‐text review …”

Section: Resultsmentioning

confidence: 99%

Global recurrence rates in diabetic foot ulcers: A systematic review and meta‐analysis

Ding

Miao

et al. 2019

Diabetes Metabolism Res

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Recurrence rates of diabetic foot ulcers vary widely in the published literature. The aim of this systematic review is to estimate recurrence rates of diabetic foot ulcers. We did a PubMed search and performed a review of reference lists for studies reporting recurrence of diabetic foot ulcers. The weighted relative risk (RR) and corresponding 95% confidence interval (CI) for recurrence was estimated. Forty‐nine studies reporting recurrence of diabetic foot ulcers were included. A pooled estimate for recurrence rate was 22.1% per person‐year (py) (95% CI, 19.0‐25.2%). Recurrence rate was 24.9% per py in Europe (95% CI, 20.0%‐29.7%), 17.8% per py in North America (95% CI, 12.7%‐22.9%), 16.9% per py in Africa (95% CI, 4.7%‐29.0%), and 17.0% per py in Asia (95% CI, 11.1%‐23.0%). Turkey had the highest recurrence rate of 44.4% per py (95% CI, 24.9%‐63.9%), and Bangladesh had the lowest of 4.3% per py (95% CI, 2.3%‐6.3%). Recurrence rates of diabetic foot ulcers before 2002, between 2002 and 2008, and after 2008 were 22.2% per py (95% CI, 17.6%‐26.8%), 21.9% per py (95% CI, 17.0%‐26.8%), and 21.8% per py (95% CI, 16.3%‐27.2%), respectively. Recurrence rates of diabetic foot ulcers are high. Recurrence rates vary widely in different regions and have decreased recently. More attention towards recurrence of diabetic foot ulcers is urgently required.

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Section: Resultsmentioning

confidence: 99%

Global recurrence rates in diabetic foot ulcers: A systematic review and meta‐analysis

Ding

Miao

et al. 2019

Diabetes Metabolism Res

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“…A recent meta-analysis (41) reported a high occurrence of more proximal amputation after transmetatarsal amputation, suggesting that the choice between the latter or other minor amputations should be tailored to the patient. For example, according to Oliver et al (42), hallux rigidus seems to be a predisposing factor for reamputation after FRA.…”

Section: Discussionmentioning

confidence: 99%

Does First Ray Amputation in Diabetic Patients Influence Gait and Quality of Life?

Aprile

Galli²,

Pitocco

et al. 2018

The Journal of Foot and Ankle Surgery

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It has recently been suggested that first ray amputation in diabetic patients with serious foot complications can prolong bipedal ambulatory status, and reduce morbidity and mortality. However, no data are available on gait analysis and quality of life after this procedure. In the present case-control study (6 amputee and 6 nonamputee diabetics, 6 healthy non-diabetic), a sample of amputee diabetic patients were evaluated and compared with a sample of nonamputee diabetic patients and a group of age-matched healthy subjects. Gait biomechanics, quality of life, and pain were evaluated. Compared with the other 2 groups, amputee patients displayed a lower walking speed and greater variability and lower ankle, knee, and hip range of motion values. They also tended to have a more flexed hip profile. Pain and lower quality of life were related to worsening biomechanical data. Our study results have shown that gait biomechanics in diabetic patients with first ray amputation are abnormal, probably owing to the severity of diabetes and the absence of the push-off phase provided by the hallux. Tailored orthotics and rehabilitation programs and a specific pain management program should be considered to improve the gait and quality of life of diabetic patients with first ray amputation.

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“…Patients with diabetic peripheral neuropathy are at high risk of plantar and distal hallux ulcerations associated with the presence of digital deformities, such as hammertoe, excessive digit length of the toe or biomechanical abnormalities (such as limited first metatarsophalangeal joint [MTPJ]), and ankle joint mobility. 10,11 Usually, a DFU located in the plantar surface of the big toe is the most common point of entry of OM of the distal phalanx of the hallux; in addition to this location, the tip of the hallux becomes another site of DFU complicated with OM as shown in Fig. 1.…”

Section: Methodsmentioning

confidence: 99%

“…11 Surgical treatment of bone infection at this level involves partial or complete phalangectomy or treatment by Distal Syme Hallux Amputation (DSHA) technique depending on the spread of the infection. 10,11 Partial hallux amputations are performed by distal phalangectomy. The hallux is approached through the plantar or distal ulcer using a fish-mouth type incision used to create a durable plantar flap, which is then rotated dorsally for primary closure (Figs.…”

Section: Methodsmentioning

confidence: 99%

Conservative surgery for chronic diabetic foot osteomyelitis: Procedures and recommendations

Lázaro‐Martínez

García‐Madrid

García‐Álvarez

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Osteomyelitis (OM) is the most frequent infection associated with diabetic foot ulcers (DFU) that typically involve the forefoot, the most common location of DFU.Conservative surgical procedures could be attractive alternative that reduces minor and major amputations and avoid future recurrence thus preserving the functionally of the foot. This review aimed to analyze and describe the current evidence on conservative diabetic foot osteomyelitis (DFO) surgical procedures depending on DFU location and indications.A narrative revision of the evidence was carried out by searching Medline through PubMed databases from inception to late July 2020 to identify retrospective, prospective, and randomized controlled trials pertaining to conservative DFO procedures on the forefoot.Seven types of conservative surgical procedures for DFO treatment in the forefoot are described in this review: (1) partial or total distal phalangectomy, (2) arthroplasty of the proximal or distal interphalangeal joint, (3) distal Syme amputation, (4) percutaneous flexor tenotomy, (5) sesamoidectomy, (6) arthroplasty of the metatarsophalangeal joint, and (7) metatarsal head resection.When indicated, conservative surgery for DFUs in patients with chronic forefoot OM is a safe and effective option that increases the chances of healing and reduces the possibility of limb loss and death compared with radical amputation procedures.Since a lack of sufficient evidence supporting this procedure exists, future investigations should be focused on the random clinical trial (RCT) design. The results of prospective trials could help surgeons select the appropriate procedure in each case in order to minimize complications.

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Influence of Hallux Rigidus on Reamputation in Patients With Diabetes Mellitus After Partial Hallux Amputation

Cited by 10 publications

References 27 publications

Global recurrence rates in diabetic foot ulcers: A systematic review and meta‐analysis

Global recurrence rates in diabetic foot ulcers: A systematic review and meta‐analysis

Does First Ray Amputation in Diabetic Patients Influence Gait and Quality of Life?

Conservative surgery for chronic diabetic foot osteomyelitis: Procedures and recommendations

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