Percutaneous Partial Bone Excision in the Management of Diabetic Toe Osteomyelitis.

IF 2.4 2区医学 Q2 ORTHOPEDICS

Foot & Ankle International Pub Date : 2023-09-01 Epub Date: 2023-06-17 DOI:10.1177/10711007231178530

Sameh R Moosa, Ali H Allan, Amr N Younes, Faris G Bakri, Nidal A Younes

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引用次数: 1

Abstract

Background: Diabetic foot osteomyelitis affecting the toes is associated with several complications including amputation. Management is variable and include medical therapy alone or coupled with surgery. Removal of infected tissues is a common therapeutic option. However, limited source data are available. This study determines the outcome and complications of percutaneous partial bone excision (PPBE) of infected bone among diabetic patients with toe osteomyelitis.

Methods: This is an uncontrolled experimental prospective study in diabetic patients who underwent PPBE of infected pieces of bone for toe osteomyelitis in the outpatient setting at a single foot clinic. All participants were followed up until the occurrence of wound healing or amputation.

Results: Forty-seven patients (mean ± SD age was 62.8 ± 11.6 years) participated. Forty-four patients (93.6%) had complete healing and 3 (6.4%) required toe amputation. The mean (±SD) wound healing time was 11 (±4.6) (range, 7-22) weeks. Diabetes mellitus type 1 and younger age were significantly associated with increased risk for amputation.

Conclusion: PPBE of infected toes in diabetic patients can be performed successfully and safely in the outpatient clinic. It can also improve healing and avoids inpatient stay.

Level of evidence: Level II, prospective cohort study.

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经皮部分骨切除治疗糖尿病性脚趾骨髓炎。

背景：影响脚趾的糖尿病足骨髓炎与包括截肢在内的多种并发症有关。管理是可变的，包括单独的药物治疗或与手术相结合。去除受感染的组织是一种常见的治疗选择。但是，可用的源数据有限。本研究确定了糖尿病脚趾骨髓炎患者经皮部分骨切除术（PPBE）治疗感染骨的结果和并发症。方法：这是一项不受控制的前瞻性实验研究，研究对象为糖尿病患者，他们在单足诊所的门诊环境中因脚趾骨髓炎接受了感染骨片PPBE。所有参与者都进行了随访，直到伤口愈合或截肢。结果：47名患者（平均 ± SD年龄为62.8岁 ± 11.6 年）参与。44名患者（93.6%）完全愈合，3名患者（6.4%）需要截肢。平均（±SD）伤口愈合时间为11（±4.6）周（范围7-22）。1型糖尿病和年龄较小与截肢风险增加显著相关。结论：糖尿病患者足趾感染PPBE可在门诊成功、安全地进行。它还可以改善愈合，避免住院。证据水平：II级，前瞻性队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot & Ankle International 医学-整形外科

CiteScore

5.60

自引率

22.20%

发文量

144

审稿时长

2 months

期刊介绍： Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers. The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008. The journal focuses on the following areas of interest: • Surgery • Wound care • Bone healing • Pain management • In-office orthotic systems • Diabetes • Sports medicine