Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

diabetes and foot amputation

Discussion in 'Diabetic Foot & Wound Management' started by Ransart, Jan 2, 2012.

  1. Ransart

    Ransart Welcome New Poster


    Members do not see these Ads. Sign Up.
    For a diabetic neuropathic patient with osteomyelitis of the 1st toe and without peripheral vascular disease, I would favor a toe amputation. Do anyone would proceed with transmeta? and if yes, why?
     
  2. I would be interested in how the patient was assessed for peripheral circulation. My concerns are the lesion was longstanding enough to develop osteomyelitis. My other thought is if the patient just had neuropathy why wasn't he able to heal? As for amputation once the circulatory status is established I would try to stick with the Hallux if possible. Studies have shown a high incidence of ulcer recurrence with midtarsal amputations.
     
  3. Ransart

    Ransart Welcome New Poster

    Peripheral vascular circulation was assessed by pulses palpation and ABI (10). I suppose that he did not heal because the wound was not offloaded and the patient was not very concerned...
     
  4. tracyd123

    tracyd123 Member

    I would recommend only the amputation of the 1st toe and then make sure appropriate footwear and offloading orthoses is given. Given that he has needed an amputation i would still probably refer for an arterial doppler to make sure there is no calcification affecting the ABI result.

    If anymore toes on that foot needed to be amputated in the future i would suggest a transmetatarsal amputation rather than leaving 3 toes, a transmet will allow a better fit in footwear and will also with the right orthoses prevent overloading of the adjacent met heads leading to further ulceration.
     
  5. cwiebelt

    cwiebelt Active Member

    i think it is best to try and preseve as much of the foot that is viable.
    i only the 1st toe has to go, then onlty take that.
    with profound neuropathy there is not the element of pain and discomfort which usally lets us know something is wrong.
    My concern is to try and prevent further ulcerations and or amputation.
    as mentioned in previous posts off load the foot, get the correct footwear extra depth toe box the lesser toes usally become contracted after loss of 1st toe
    and prehaps soem education might be an idea on warning signs and prevetion
    Chris
     
Loading...

Share This Page