Armstrong DG, Lavery LA, Vazquez JR, Short B, Kimbriel HR, Nixon BP, Boulton AJ, et al.
Diabetes care. Date of publication 2003 Dec 1;volume 26(12):3284-7.
1. Diabetes Care. 2003 Dec;26(12):3284-7.
Clinical efficacy of the first metatarsophalangeal joint arthroplasty as a
curative procedure for hallux interphalangeal joint wounds in patients with
diabetes.
Armstrong DG(1), Lavery LA, Vazquez JR, Short B, Kimbriel HR, Nixon BP, Boulton
AJ.
Author information:
(1)Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs
Medical Center, Tucson, Arizona, USA. armstrong@usa.net
Erratum in
Diabetes Care. 2004 Feb;27(2):641.
OBJECTIVE: To evaluate the safety and efficacy of first metatarsophalangeal joint
arthroplasty compared with standard, nonsurgical management of wounds at the
plantar hallux interphalangeal joint in patients with diabetes.
RESEARCH DESIGN AND METHODS: We evaluated 41 patients with ulcers classified as
University of Texas Grade 1A or 2A at the plantar aspect of the hallux
interphalangeal joint using a case-control model [correction]. Case subjects were
patients treated with resectional arthroplasty and control subjects received
standard nonsurgical care. Both groups received standard off-loading and wound
care. Outcomes included time to healing, reulceration, infection, and amputation.
RESULTS: The surgery group healed significantly faster than patients in the
standard therapy group (standard 67.1 +/- 17.1 versus surgery 24.2 +/- 9.9 days,
P = 0.0001), and they had fewer recurrent ulcers (standard 35.0 versus surgery
4.8%, P = 0.02, odds ratio 7.6, 95% CI 1.1-261.7) Both groups had similar rates
of infection (standard 38.1 versus surgery 40.0%, P = 0.9) and amputation
(standard 10.0 versus surgery 4.8%, P = 0.5).
CONCLUSIONS: Results suggest that resectional arthroplasty is a safe and
effective procedure to treat wounds of the plantar hallux compared with
nonsurgical therapy.
PMID: 14633815 [Indexed for MEDLINE]
