Abstract
Aims: Foot deformities following diabetic-neuropathic osteoarthropathy are often responsible for major amputations at the lower limbs. To preserve foot and lower limb length salvage procedures have to be introduced. Methods: In 59 patients with severe deformities of the foot (Sanders II-IV) surgical reposition and resection of necrotic bony substance has resulted in an axial correction of foot-malposition. Stabilization was effected using a fixateur externe device (Hoffmann II) over a period of 6 weeks. After removal of the fixateur externe stabilization of the lower leg was performed for another 6 weeks by means of orthotic devices. Results: Surgical reposition and stabilization in a total of 59 feet has resulted in 57 cases to conservation of the foot, in 2 cases later amputation was necessary. Immobilization in the fixateur externe resulted in a fast detumenescence of accompanying oedemas and in wound healing without special problems. Post-treatment examination after two years on the average revealed in all patients a stable pseudarthrosis without bony connection. 43 from 57 patients after about 6 months were provided with orthopaedic footwear. Conclusions: Surgical procedures which refrain from the use of implants and which do not increase arthropathic activities are capable to correct severe malpositioning of the foot without increasing the activity of arthropathy and result in superior long-term results in diabetic patients. They should therefore be applied with preference.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
