Abstract
To evaluate the results of the reconstructive surgical treatment of complicated forms of infected osteoarthropathy with diabetic foot syndrome (DFS).
The analysis of the results of the treatment of 58 patients with infectious complications of osteoarthropathy with the neuropathic form of the DFS, the average age 57.7+1.2 years. In 5 patients with Type I according to the Sanders & Frykberg classification, grade C according to the Roger classification of with neuropathic ulcers caused by deformation of the bones we employed corrective mini-osteotomy.
In 32 patients with Type I, grade D with the infected ulcers associated with destruction of the metatarsal bones and the metatarsophalangeal joints, we performed the resection of the affected bones, subsequently filling the defects with antibiotic impregnated collagen sponge (AICS*), and then we closed the wound with primary suture.
In 15 patients with Type II, grade D we performed the resection of the affected bones and stabilize the mid-foot using compressive screws and AICS.
In 4 patients with Type III, grade D we perfomed the following resection of the affected bones we used AICS and the extrafocal corrective osteosynthesis using the Ilizarov's method.
In 2 patients with Type IV+V, grade D we did an amputation using the Syme's technique and osteosynthesis using the Ilizarov's method.
There was one case of septic instability of the compressive screw after more than one month: the screw was then removed; and there was one case of an unstable bone fragment: its removal was necessary. No recurrence of the trophic ulcers or osteomyelitis of the foot bones was observed during a 6 – 24 mounth follow-up in any other treated patients.
The described methods are promising in the treatment of patients with DFS; their effectiveness can be evaluated after randomized trials will be completed.
