Evaluation of Hallux Interphalangeal Joint Arthroplasty Compared With Nonoperative Treatment of Recalcitrant Hallux Ulceration
| Autor: | Nicole Nicolosi, Eric Lew, Patrick McKee |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Foot Orthoses Toe Joint Amputation Surgical Arthroplasty Diabetic Neuropathies Recurrence Statistical significance Diabetes mellitus medicine Deformity Humans Orthopedics and Sports Medicine Retrospective Studies Wound Healing business.industry Ulcer recurrence Retrospective cohort study Middle Aged medicine.disease Diabetic Foot Nonoperative treatment Surgery Hallux Female medicine.symptom Interphalangeal Joint business Follow-Up Studies |
| Zdroj: | The Journal of Foot and Ankle Surgery. 54:541-548 |
| ISSN: | 1067-2516 |
| Popis: | Patients with chronic diabetes can develop plantar hallux ulcerations secondary to neuropathy, increased pressure, and deformity. The present retrospective study evaluated the efficacy of hallux interphalangeal joint (HIPJ) arthroplasty to address recalcitrant ulceration. Two groups of patients with diabetes were compared: a surgical group of 13 patients and a nonsurgical standard therapy group of 13 patients. The patients in the surgical group underwent HIPJ arthroplasty. All the patients in the standard therapy group received local wound care and offloading. The mean duration of follow-up was 19.5 (range 1.2 to 47.9) months, and the mean age was 55 ± 13.0 years. Statistical significance was found in the surgical group for faster time to healing (3.5 weeks [2.5, 4.25] vs 9 weeks [2, 17.29], p = .033) and lower incidence of ulcer recurrence (8% ± 7.69 vs 54% ± 53.85, p = .031). There were also fewer amputations in the surgical group (0% ± 0 vs 38% ± 38.6, p = .063). To our knowledge, only 1 other published study has evaluated HIPJ arthroplasty as a treatment of recalcitrant hallux ulceration. The present study adds comparison data from a nonoperative standard therapy group and found that HIPJ arthroplasty is an effective curative treatment option to address chronic plantar hallux ulcerations in diabetic patients with neuropathy. |
| Databáze: | OpenAIRE |
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