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Clinical report
Minimally invasive offloading osteotomy in the treatment of diabetic foot ulcer: Analysis of 25 patients
Osteotomía de descarga ambulatoria mínimamente invasiva en el tratamiento de la úlcera de pie diabético: análisis de 25 pacientes
José Vicente Gil Boixa,
Corresponding author
, Melchor Lladó Vidala, Elena Mena Ribasa, Jordi Viadé Juliàb, Francisco Javier Fanjul Losac, Santiago Tofé Povedanoa
a Servicio de Endocrinología y Nutrición, Hospital Universitario Son Espases, Palma, Balearic Islands, Spain
b Servicio de Endocrinología y Nutrición, Hospital Universitario Trias i Pujol, Badalona, Barcelona, Spain
c Servicio de Medicina Interna, Hospital Universitario Son Espases, Palma, Balearic Islands, Spain
Received 08 July 2023. Accepted 15 November 2023
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Tables (3)
Table 1. Baseline patient characteristics (n = 23).
Table 2. Chronic DM complications.
Table 3. Subgroup results (n = 18).
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Abstract
Introduction

Diabetes mellitus and its complications are one of the main burdensome health problems at the present time. The diabetic foot is one of the most characteristic complications.

Material, methods and objective

The objective of this work is to describe the results and complications obtained in a series of 25 cases of diabetic foot treated by minimally invasive offloading osteotomies.

Results

Of the total number of interventions, 18 were performed on refractory ulcers with prior conservative treatment, for a mean (±SD) duration of 29.28 ± 18.42 months. The mean follow-up period was 26.46 ± 4.89 months. Weighted pooled rates of response to treatment were as follows: 100% for ulcer healing (with a mean healing time of 22.41 ± 7.01 days), 5.56% for ulcer recurrence, and 16.67% for ulcer transfer. In 7 cases, a preventive intervention was performed on areas with pre-ulcerative lesions. Of the total number of cases, only 3 presented mild infection in the intervention area.

Conclusions

Minimally invasive offloading osteotomy is a technically simple intervention, which presents a high success rate with minimal complications in our series.

Keywords:
Amputation
Diabetic foot ulcer
Minimally invasive surgery
Offloading osteotomy
Osteomyelitis
Resumen
Introducción

La diabetes mellitus y sus complicaciones suponen uno de los mayores problemas sanitarios en la actualidad. La úlcera del pie diabético es una de las complicaciones más características.

Material, métodos y objetivo

El objetivo es describir los resultados y complicaciones obtenidos en una serie de 25 casos de úlcera neuropática tratada mediante osteotomías de descarga mínimamente invasivas y ambulatorias.

Resultados

Del total de intervenciones, 18 fueron sobre úlceras refractarias a un tratamiento conservador previo de una duración media ± desviación estándar de 29,28 ± 18,42 meses. El período de seguimiento fue 26,46 ± 4,89 meses. Las tasas agrupadas de respuesta al tratamiento fueron: 100% cicatrización de la úlcera (tiempo medio de cicatrización 22,41 ± 7,01 días), 5,56% recurrencia de la úlcera, 16,67% translocación de la úlcera. En 7 casos se realizó una intervención preventiva sobre áreas con lesiones pre-ulcerosas. Del total, únicamente 3 presentaron infección leve en la zona de la intervención.

Conclusiones

La osteotomía de descarga mínimamente invasiva ambulatoria es un procedimiento técnicamente sencillo, que presenta una alta tasa de éxito con mínimas complicaciones en nuestra serie.

Palabras clave:
Amputación
Úlcera del pie diabético
Cirugía mínimamente invasiva
Osteotomía de descarga
Osteomielitis

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