SURGICAL RECONSTRUCTION OF THE DIABETIC FOOT - A SALVAGE APPROACH FORMIDFOOT COLLAPSE

Between 1985 and 1993, 18 patients representing 21 feet underwent surg ical reconstruction for diabetic neuroarthropathy with collapse of the midfoot. Forty-seven percent (10/21) of these feet presented with pla ntar pressure ulcers. Reconstruction involved reduction and fusion of collapsed joints, using internal fixation to restore foot shape and im prove weightbearing alignment. The average follow-up in these patients was 28 months (range, 6-84 months). Limb salvage was obtained in 18 o f 21 feet. Average time to radiographic union was 5 months (range, 3-9 months). Improvement in shoe fit and ambulatory status was noted for 13 of the 15 patients who had successful reconstruction, Forty-seven p ercent of the reviewed cases were without any complication throughout their postoperative course, Seventy percent of the presenting ulcers h ealed without incident, There were no recurrent midfoot ulcers.