Hand osteomyelitis in arterial calcification, diabetes mellitus and end-stage renal failure : a comparison of 210 cases over 12 years
| Autor: | Jennifer Caddick, Dallan Dargan, Matthew Wyman, Victoria Giblin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Ischemia Amputation Surgical 03 medical and health sciences 0302 clinical medicine peripheral arterial disease Diabetes mellitus amputation Diabetes Mellitus Medicine Humans 030212 general & internal medicine 030203 arthritis & rheumatology Debridement business.industry Osteomyelitis medicine.disease Hand Surgery Arterial calcification Amputation vascular calcification Cohort Kidney Failure Chronic Full Length Articles ischaemia business debridement Calcification |
| Zdroj: | The Journal of Hand Surgery, European Volume |
| ISSN: | 1753-1934 |
| Popis: | We present 210 patients with hand osteomyelitis in 246 rays over 12 years, including detailed analysis of 29 patients in this cohort with digital artery calcification evident on plain X-ray. Overall 71 patients had diabetes mellitus and/or end-stage renal failure, including 28 of 29 patients with calcification. In the calcification group, 17 patients had ipsilateral arteriovenous fistulae, five had steal syndrome and 15 had digital ulceration or skin necrosis. Compared with 181 controls, patients with calcification had more affected bones, polymicrobial infections, surgical procedures, phalanges and digits amputated and had higher mortality at 1 year (12 of 29) and 5 years (20 of 29), as a result of comorbidities. Absence of calcification in 43 patients with diabetes and/or end-stage renal failure was associated with better outcomes on all the above parameters. Early amputation to maximize disease-free survival may be appropriate for patients with hand osteomyelitis and arterial calcification. Level of evidence: IV |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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