BACKGROUND: Diabetic foot ulceration is a worldwide health problem. Approxi
mately 15% of the 10 million diabetic patients in the United States will de
velop a foot ulceration at some time in their lives. The presence of a foot
ulcer in this population is extremely debilitating and dramatically increa
ses the risk of lower extremity amputation, accounting for approximately 67
,000 lost limbs each year. Additionally, the costs associated with treating
foot ulcers in diabetic patients is a major expense in the overall care of
this patient group.
METHODS: An 11-year retrospective study was conducted to evaluate 101 conse
cutive patients with diabetic ulcers of the forefoot who were treated using
resection of the metatarsal head as the primary means of obtaining wound c
losure.
RESULTS: The results indicate that 88% of the ulcers were healed by using t
his technique, and relatively move rapidly than would be expected when comp
ared with historical norms.
CONCLUSIONS: Resection of the metatarsal head is a safe and relatively inex
pensive procedure that facilitates closure of the lesion, helps to control
infection, and prevents countless and costly amputations. Am J Surg. 1998;1
76:436-441. (C) 1998 by Excerpta Medica, Inc.