Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.11851/7260
Title: Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers
Authors: Akkurt, Mehmet Orcun
Demirkale, İsmail
Oznur, Ali
Keywords: Diabetic foot ulcer
diabetes mellitus
Ilizarov technique
external fixation
surgical debridement
Issue Date: 2017
Publisher: Taylor & Francis Ltd
Abstract: Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers. Methods: The study included 23 patients with diabetic hindfoot ulcers who were treated with radical excision of the necrotic tissue and application of circular external fixation. The treatment protocol was a combination of magnetic resonance imaging (MRI)-guided debridement of the necrotic tissues and application of an Ilizarov external fixator in plantarflexion to decrease the soft-tissue defect. Primary outcome measures were total cure of infection and obvious healing of the osteomyelitis at 12 weeks determined by MRI, and clinical cure through objective assessment of the appearance of the wound. Results: The wounds healed in 18 of the 23 patients (78%), partial recovery occurred and subsequent flap operation was performed in three patients (13%), and below-the-knee amputation was performed in two patients (9%). Conclusions: This surgical protocol is effective in ameliorating diabetic hindfoot ulcers with concomitant calcaneal osteomyelitis, and satisfactorily reduces the need for amputation.
URI: https://doi.org/10.1080/2000625X.2017.1264699
https://hdl.handle.net/20.500.11851/7260
ISSN: 2000-625X
Appears in Collections:Cerrahi Tıp Bilimleri Bölümü / Department of Surgical Sciences
PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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