The treatment of diabetic foot ulcers is still challenging, but the application of minimally invasive surgery now represents a strategic management of these lesions to achieve health goals, highly uncertain until a few years ago. Minimally invasive distal metatarsal diaphyseal osteotomy (DMDO) is based on a distal osteotomy proximal to the metatarsal neck to reduce the pressure on the ulcer and favor its healing. The DMDO technique enables the restoration of the original harmonic distal parabola of the forefoot when possible, or the creation of a new balanced forefoot arch, promoting the healing of chronic pressure ulcers. This technique, in association with percutaneous osteotomies and tenotomies of phalanges, protects diabetic patients with minimal tissue damage, immediate postoperative weight bearing, and reduced risk of potential infections, because it does not require metal fixation. In a recent preliminary prospective study, DMDO was proved to be a safe and effective method for promoting the healing of chronic diabetic foot ulcers, regardless of their severity.
Minimally Invasive Surgery: Osteotomies for Diabetic Foot Disease
Biz, Carlo
;Ruggieri, Pietro
2020
Abstract
The treatment of diabetic foot ulcers is still challenging, but the application of minimally invasive surgery now represents a strategic management of these lesions to achieve health goals, highly uncertain until a few years ago. Minimally invasive distal metatarsal diaphyseal osteotomy (DMDO) is based on a distal osteotomy proximal to the metatarsal neck to reduce the pressure on the ulcer and favor its healing. The DMDO technique enables the restoration of the original harmonic distal parabola of the forefoot when possible, or the creation of a new balanced forefoot arch, promoting the healing of chronic pressure ulcers. This technique, in association with percutaneous osteotomies and tenotomies of phalanges, protects diabetic patients with minimal tissue damage, immediate postoperative weight bearing, and reduced risk of potential infections, because it does not require metal fixation. In a recent preliminary prospective study, DMDO was proved to be a safe and effective method for promoting the healing of chronic diabetic foot ulcers, regardless of their severity.File | Dimensione | Formato | |
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