Percutaneous tenotomy for the treatment of diabetic toe ulcers.

Abstract

BACKGROUND:

Foot ulcers have been implicated as a causative factor in diabetic foot amputations. The purpose of this study was to evaluate treating foot ulcers in patients with diabetes by percutaneous tenotomy.

METHODS:

We retrospectively reviewed the computerized medical files of 83 patients treated for foot ulcers by percutaneous tenotomies. Results were analyzed on the basis of indication and per patient.

RESULTS:

The 83 patients had 160 tenotomies for 4 indications: 103 tip-of-toe ulcers (treated by flexor digitorum longus tenotomy), 26 cock-up/dorsal ulcers (extensor digitorum longus tenotomy), 21 kissing ulcers (extensor digitorum longus and/or flexor digitorum longus tenotomies), and 10 plantar metatarsal ulcers (extensor digitorum longus with or without flexor digitorum longus tenotomy). Healing at 4 weeks was 98%, 96%, 81%, and 0%, respectively. The complication rate was very low, with the exception of "transfer lesions," where an adjacent toe became involved and needed subsequent tenotomy in 8% of tip-of-toe ulcers.

CONCLUSIONS:

Percutaneous tenotomy was an effective and safe method for treating toe ulcers in neuropathic patients. It was not effective in treating plantar metatarsal ulcers.

LEVEL OF EVIDENCE:

Level IV, case series.

• Authors: Eran Tamir, Mordechai Vigler, Erez Avisar, Aharon S Finestone
• Journal: Foot & ankle international (Foot Ankle Int) Vol. 35 Issue 1 Pg. 38-43 (Jan 2014) ISSN: 1944-7876 [Electronic] United States
• PMID: 24131679 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Diabetic Foot (physiopathology, surgery)
• Diabetic Neuropathies (complications, etiology)
• Female
• Foot Deformities, Acquired (complications)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Tenotomy (methods)
• Toes (physiopathology)
• Wound Healing