Online ISSN: 2515-8260

Keywords : non surgical offloading and surgical offloading

Metatarsal head resection for diabetic foot non-infected neuropathic ulcers versus non-surgical treatment

Michael Samuel Ayad MD; Amr Hamdy MD; Mostafa M. Abdelghany MD; Mina Maher Raouf MD; Moamen Mostafa Nagy MD

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1235-1242

Introduction:  Conservative treatment of diabetic foot neuropathic ulcer includes offloading with orthopaedic shoes and  plaster casts is usually effective in achieving primary closure of foot ulcers but  take along time and recurrence rates are high. The surgery alleviates the pressure under the bony prominence, thus enabling prompt ulcer healing in short time with a lower chance of recurrence. The purpose of this protocol is to compare offloading surgery to non-surgical treatment for patients with diabetic foot neuropathic ulcers.
Methods: This study included fourty patients presented with neuropathic diabetic foot ulcer. Two groups group A twenty cases were managed  surgically by tenotomy and metatarsal head osteotomy, group B  twenty cases  were managed conservatively includes offloading with orthopaedic shoes and  plaster casts.
Results:  In our study twenty  cases group a were managed surgically take three weeks to five weeks to heal with no recurrence, group b twenty cases were managed conservatively take twelve weeks  to twenty four weeks to  heal with recurrence in eight  patients.
Conclusion:The best current strategy for management of diabetic foot neuropathic ulcer is surgical offloading.