Tendon Lengthening for Neuropathic Foot Problems

Laborde, James Monroe

doi:10.3928/01477447-20100329-26

Cited by 16 publications

(46 citation statements)

References 48 publications

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“…New techniques of tendon balancing have been shown to speed healing of ulcers, decrease ulcer recurrence and LEA. This approach could be incorporated as part of initial treatment of foot ulcers in the future [32]. …”

Section: Discussionmentioning

confidence: 99%

Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Indonesia

Pemayun

Naibaho

2017

Diabetic Foot & Ankle

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Background: This study attempted to determine the disease burden in terms of clinical profile and outcome of diabetic foot ulcer (DFU) admissions at a tertiary care hospital in a developing country. Methods: In this descriptive study, the data were collected from the medical record of diabetic patients with foot ulcer who were treated in Dr. Kariadi General Hospital during a 3-year period. The demographic characteristic, type of foot lesion, etiology, isolated microorganism, treatment, and outcome were reviewed. Results: Foot problems accounted for 16.2% of total diabetic admission (n = 1429). All patients had type 2 diabetes with no gender predominance. The mean age was 54.3 ± 8.6 years and diabetes control was very poor. Before admission, the ulcers had already developed for 4.7 ± 2.9 weeks; however, the majority of patients were unaware of the preceding causes. Ulcers were neuropathic in 42.2% of cases, neuroischemic in 29.9%, and pure ischemic at lesser percentage. More than 70% of ulcers were in Wagner grade ≥3 with infection event in nearly all patients. The most common isolates from culture were Gram-negative bacteria. A total of 98 (36.3%) lower extremity amputations (LEAs) at various level of the foot were carried out, including major LEA in 24 patients and multiple amputations in seven patients. Mortality rate due to DFU reached 10.7%. Conclusions: Diabetic foot problems constitute a source of morbidity, a reason for LEA surgery as well as being a cause of death among patients with diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Indonesia

Pemayun

Naibaho

2017

Diabetic Foot & Ankle

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“…[46][47][48][49][50][51][52] Many authors have stated that tendon imbalance correction, particularly Achilles or gastroc-soleus tightness correction can help address foot problems and avoid ulcers. [53][54][55] Flexor tenotomies have also been suggested to decrease metatarsal head ulcers in patients with claw toes. [56] Nerve decompression Lee Dellon's 1988 article first hypothesized that systemic metabolic abnormalities of diabetes rendered the peripheral nerve susceptible to chronic nerve compression.…”

Section: Vacuum-assisted Closure (Vac)/negative Pressure Wound Therapmentioning

confidence: 99%

Trophic ulcers-Practical management guidelines

Puri

Venkateshwaran

Khare

2012

Indian J Plast Surg

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The management of patients with trophic ulcers and their consequences is difficult not only because it is a recurrent and recalcitrant problem but also because the pathogenesis of the ulcer maybe different in each case. Methodically and systematically evaluating and ruling out concomitant pathologies helps to address each patient's specific needs and hence bring down devastating complications like amputation. With incidence of diabetes being high in our country, and leprosy being endemic too the consequences of neuropathy and angiopathy are faced by most wound care specialists. This article presents a review of current English literature available on this subject. The search words were entered in PubMed central and appropriate abstracts reviewed. Relevant full text articles were retrieved and perused. Cross references from these articles were also reviewed. Based on these articles and the authors’ experiences algorithms for management have been presented to facilitate easier understanding. It is hoped that the information presented in this article will help in management of this recalcitrant problem.

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“…5 This increased stress in the foot can be decreased by tendon lengthening, which can resolve foot pain and ulcers. 5,6 Foot ulcers commonly become infected and can lead to amputation. 7 Approximately 85% of patients with diabetes who have amputations have foot ulcers.…”

mentioning

confidence: 99%

“…2,5,6,[8][9][10][11][12] Treatment of foot ulcers with tendon lengthening has good support in the literature, both for healing ulcers and for preventing recurrence. 2,5,6,[8][9][10][11][12] Some authors have also recommended tendon lengthening to prevent forefoot ulcers in at-risk patients. 3,6,13 For the Charcot foot, there is also evidence that primary GSR contributes to ulcer healing and mitigates progression of deformity, ulceration, and amputation.…”

mentioning

confidence: 99%

“…2,5,6,[8][9][10][11][12] Some authors have also recommended tendon lengthening to prevent forefoot ulcers in at-risk patients. 3,6,13 For the Charcot foot, there is also evidence that primary GSR contributes to ulcer healing and mitigates progression of deformity, ulceration, and amputation. 5 A more detailed literature review of the benefits of tendon lengthening for diabetic foot problems was previously published in this journal.…”

mentioning

confidence: 99%

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