FHL Tendon Transfer in Diabetics for Treatment of Non-Healing Plantar Heel Ulcers

Kim, J-Young; Lee, Inmook; Seo, Kyung-Won; Jung, Woo-Sung; Kim, Byung-Kwan

doi:10.3113/fai.2010.0480

Cited by 20 publications

(15 citation statements)

References 24 publications

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“…Two non‐controlled studies from the same research group, one on the effects of plantar fascia release in 60 patients with forefoot ulcers and one on the effect of flexor hallucis longus tendon transfer in nine patients with plantar heel ulcers, presented no ulcer recurrence after 24 months follow‐up .…”

Section: Resultsmentioning

confidence: 99%

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Netten

Raspovic

Lavery

et al. 2016

Diabetes Metabolism Res

291

226

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Background Prevention of foot ulcers in patients with diabetes is extremely important to help reduce the enormous burden of foot ulceration on both patient and health resources. A comprehensive analysis of reported interventions is not currently available, but is needed to better inform caregivers about effective prevention. The aim of this systematic review is to investigate the effectiveness of interventions to prevent first and recurrent foot ulcers in persons with diabetes who are at risk for ulceration.

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Section: Resultsmentioning

confidence: 99%

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Netten

Raspovic

Lavery

et al. 2016

Diabetes Metabolism Res

291

226

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“…Summary of the literature : We found two RCTs, seven cohort studies, and 27 noncontrolled studies . We will describe the results per the specific surgical intervention.…”

Section: Resultsmentioning

confidence: 99%

“…They found in a total 58 treated patients (all IWGDF risk 3) no ulcer in a mean of 11 to 31 months of follow-up [92][93][94]. Tendon transfer and fascia release: Two noncontrolled studies from the same research group, one on the effects of plantar fascia release in 60 patients with a forefoot ulcer and one on the effect of flexor hallucis longus tendon transfer in nine patients with a plantar heel ulcer, found no ulcer recurrence after 24-month follow-up 98,99. Evidence statement: In selected patients with diabetes and a nonhealing toe ulcer, digital flexor tendon tenotomy may reduce the risk of a recurrent toe ulcer after healing of their current ulcer, when compared with nonsurgical treatment.Evidence statement: In patients with diabetes at high risk for ulceration (IWGDF risk 3), and with abundant callus on the tip of their toe, a hammertoe or with thickened nails, flexor tenotomy may reduce the risk of developing an ulcer.…”

mentioning

confidence: 99%

“…From the limited number of controlled studies, Achilles tendon lengthening, single or pan-metatarsal head resection, and metatarsophalangeal joint arthroplasty appear to reduce ulcer recurrence risk in selected patients with nonhealing ulcers when compared with nonsurgical treatment 67,68,[70][71][72][83][84][85][86][87][88][89]. Several other surgical offloading procedures, such as osteotomy and digital flexor tendon tenotomy, are promising for helping prevent ulcer recurrence 73,[90][91][92][93][94][95][96][97][98][99]. Based on the results of a few case series, flexor tenotomy may even have value in preventing a first-ever foot ulcer in patients with abundant callus on the tip of their toes or thickened nails [92][93][94].…”

mentioning

confidence: 99%

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Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Netten

Raspovic

Lavery

et al. 2020

Diabetes Metabolism Res

169

330

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Prevention of foot ulcers in patients with diabetes is important to help reduce the substantial burden on both patient and health resources. A comprehensive analysis of reported interventions is needed to better inform healthcare professionals about effective prevention. The aim of this systematic review is to investigate the effectiveness of interventions to help prevent both first and recurrent foot ulcers in persons with diabetes who are at risk for this complication. We searched the available medical scientific literature in PubMed, EMBASE, CINAHL, and the Cochrane databases for original research studies on preventative interventions. We screened trial registries for additional studies not found in our search and unpublished trials. Two independent reviewers assessed data from controlled studies for methodological quality, and extracted and presented this in evidence and risk of bias tables. From the 13,490 records screened, 35 controlled studies and 46 non‐controlled studies were included. Few controlled studies, which were of generally low to moderate quality, were identified on the prevention of a first foot ulcer. For the prevention of recurrent plantar foot ulcers, there is benefit for the use of daily foot skin temperature measurements, and for therapeutic footwear with demonstrated plantar pressure relief, provided it is consistently worn by the patient. For prevention of ulcer recurrence, there is some evidence for providing integrated foot care, and no evidence for a single session of education.Surgical interventions have been shown effective in selected patients, but the evidence base is small. Foot‐related exercises do not appear to prevent a first foot ulcer. A small increase in the level of weight‐bearing daily activities does not seem to increase the risk for foot ulceration. The evidence base to support the use of specific self‐management and footwear interventions for the prevention of recurrent plantar foot ulcers is quite strong. The evidence is weak for the use of other, sometimes widely applied, interventions, and is practically non‐existent for the prevention of a first foot ulcer and non‐plantar foot ulcer.

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“…Adjunctive treatment of diabetic ulcerations by lengthening, rerouting, or transecting tendons in the lower extremity has been previously described (9)(10)(11)(12)(13)(14). Specifically, lengthening of the tibialis anterior tendon has been successfully used for surgical treatment of clubfoot (15).…”

Section: Discussionmentioning

confidence: 98%

Tibialis Anterior Tendon Lengthening: Adjunctive Treatment of Plantar Lateral Column Diabetic Foot Ulcers

Kim

Steinberg

Kikuchi

et al. 2015

The Journal of Foot and Ankle Surgery

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FHL Tendon Transfer in Diabetics for Treatment of Non-Healing Plantar Heel Ulcers

Abstract: We believe that Achilles tendon reconstruction using an FHL transfer for non-healing plantar heel ulcers resulting from a triple Hoke lengthening of the Achilles tendon is a good treatment option for diabetic patients.

Cited by 20 publications

References 24 publications

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Tibialis Anterior Tendon Lengthening: Adjunctive Treatment of Plantar Lateral Column Diabetic Foot Ulcers

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