PLANTAR FOREFOOT ULCERATION WITH EQUINUS DEFORMITY OF THE ANKLE IN DIABETIC PATIENTS: THE EFFECT OF TENDO-ACHILLES LENGTHENING AND TOTAL CONTACT CASTING

Orthopedics - Tập 19 Số 5 - Trang 465-475 - 1996
Sheldon S. Lin1, Thomas H. Lee2, Keith L. Wapner3
1Department of Orthopedics, University of Medicine & Dentistry of New Jersey, New Jersey Medical School, Newark, USA.
2Grant Orthopedic Institute
3Drexel University

Tóm tắt

ABSTRACTBetween 1993 and 1995, 93 neuropathic diabetes mellitus patients with foot ulcers underwent a total contact cast (TCC) protocol. A randomly chosen group of 21 patients (Group I) demonstrated ulcer healing in a mean time of 43.5 days. Despite 9 weeks of TCC, 15 patients (Group II) with forefoot ulcers failed to heal. Physical examination of Group I revealed plantarflexion/dorsiflexion range of motion of the ankle of 33.871.9° compared to 32.3°/-10.5° of Group II, demonstrating an ankle equinus deformity and limited joint motion. Group II patients underwent a correction of the equinus deformity with percutaneous tendo-Achilles lengthening (TAL), followed by a TCC. All but one ulcer (93.3%) healed within 39.4 days. Four (19.0%) ulcers recurred (at the same site) in Group I, compared to none in Group II at the latest follow up of 17.3 months. Surgical correction with percutaneous TAL and TCC results in healing of forefoot ulcer and helps prevent ulcer recurrence.

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Orthopedics

Tập 19 Số 5

465-475

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