[Minor amputations for diabetic foot syndrome]

Orthopade. 2009 Dec;38(12):1160-70. doi: 10.1007/s00132-009-1502-y.
[Article in German]

Abstract

Minor amputations are frequently performed for neuroischemic or neuropathic lesions of the diabetic foot. Depending on the definition used, minor amputations can range from toe to Syme amputations. Minor amputations are often combined with necrosectomy and débridement. For early and optimal rehabilitation, as much vital tissue as possible should be conserved, especially considering the skeletal structures of the foot (borderline amputation). Minor amputations are of utmost importance for the prevention of ascending infections and reduce the duration of clinical and outpatient treatment. Minor amputations should be performed only by experienced surgeons and only if arterial perfusion is sufficient. They should be as tissue-conserving as possible and structured interdisciplinary postoperative care is mandatory. Metabolic control should be optimized. Controversial opinions exist with respect to the use of tourniquets, conservation or resection of cartilage and sesamoid bones, open amputation or primary closure of the wound, interdigital spacer function of toes, aseptic proximal transection of tendons, postoperative wound care, negative-pressure wound treatment and antibiotic therapy. In view of these controversies the most important minor amputation techniques are described and discussed.

Publication types

  • English Abstract

MeSH terms

  • Amputation, Surgical / instrumentation*
  • Amputation, Surgical / methods*
  • Amputation, Surgical / trends
  • Diabetic Foot / surgery*
  • Humans
  • Minimally Invasive Surgical Procedures / methods*
  • Minimally Invasive Surgical Procedures / trends*