Abstract
Aims: Only gangrene of the entire foot and life-threatening sepsis with severe infection require a high amputation. Method: Between 1984 and 1999, 188 amputations in the area of the lower extremity were carried out at Bad Düben specialist hospital for orthopaedics. In 31 cases, partial amputation (so-called amputation of border zones) was required in the area of the foot owing to diabetic foot syndrome. The medical records were analysed and the patients who were still living underwent a follow-up examination; 8 patients had died. Results: Of the 31 patients, 20 were men and 11 were women. From 1982 to 1987 there were 4 partial amputations of the foot, from 1988 to 1993 there were 12 and from 1994 to 1999 there were 11. The average age was 69.1 years. In 11 cases, amputation of the lower leg as a subsequent operation was necessary. Here the average age was 71,8 years. It was noted that from 1994 to 2001 subsequent amputation of the lower leg had only been required twice (eight times from 1984 to 1993). The patients who underwent a follow-up examination were satisfied after partial amputation of the foot. Conclusions: For diabetic feet with neuropathy and infection, partial amputation of the foot can be regarded as the treatment of choice. Prompt referral to hospital is necessary to ensure optimum glucose adjustment and any treatment required for accompanying diseases. With interdisciplinary management between the physician, vascular surgeon and orthopaedist, and with treatment in a team with the orthopaedic shoemaker, in addition to surgical measures, we the necessary local can prevent gangrene of the entire foot and life-threatening sepsis from leading to a high amputation.
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.
