Review ArticlePercutaneous Flexor Tenotomy for Treatment of Neuropathic Toe Ulceration Secondary to Toe Contracture in Persons with Diabetes: A Systematic Review
Section snippets
Materials and Methods
Eleven electronic databases, including the American College of Physicians Journal Club (http://www.acpjc.org/), Cumulative Index of Nursing and Allied Health Literature (http://www.ebscohost.com/cinahl/), Cochrane Library (http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME?CRETRY=1&SRETRY=0), Cochrane Controlled Trials Register (http://www.ovid.com/site/products/ovidguide/cctrdb.htm), Cochrane Database of Systematic Reviews (http://www.cochrane.org/reviews/), Cochrane Methodology
Results
The search for potentially eligible information for inclusion in the systematic review yielded a total of 16 references. All other references identified, both published and unpublished, were obtained and reviewed by the authors in March 2009. After considering all of the potentially eligible references, only 2 (12.5%) of the studies met all of the inclusion criteria (Table 1) 40, 43. Both studies involved percutaneous flexor tenotomy of the hallux and/or lesser toes with immediate ambulation as
Discussion
The purpose of this systematic review was to evaluate the best evidence available for performing percutaneous flexor tenotomy of the hallux and/or lesser toes for the treatment of neuropathic toe ulceration secondary to toe contracture in persons with diabetes with regard to efficacy and safety. Only 2 studies could be identified that met the inclusion criteria, neither of which were prospective in design or involved a control group 40, 43. In addition, neither of these studies corresponded to
References (56)
- et al.
Cost of diabetes-related amputations in minorities
J Foot Ankle Surg
(1998) - et al.
Protocol for treatment of diabetic foot ulcers
Am J Surg
(2004) - et al.
The diabetic foot
Surg Clin
(2007) Pressure and the diabetic foot: clinical science and offloading techniques
Amer J Surg
(2004)Prophylactic surgery in the diabetic patient
Clin Podiatr Med Surg
(1987)- et al.
Is prophylactic diabetic foot surgery dangerous?
J Foot Ankle Surg
(1996) - et al.
Toe amputation in the diabetic patient
Surgery
(1997) - et al.
Amputation of the toes for vascular disease: fate of the affected leg
Lancet
(1976) - et al.
The natural history of great toe amputations
J Foot Ankle Surg
(1997) - et al.
Costs and duration of care for lower extremity ulcers in patients with diabetes
Clin Ther
(1998)
Incidence, outcomes, and cost of foot ulcers in patients with diabetes
Diabetes Care
The cost of diabetic foot conditions
Ceylon Med J
Standard, appropriate, and advanced care and medical-legal considerations: part one—diabetic foot ulcerations
Wounds
Evidence-based protocol for diabetic foot ulcers
Plast Reconstr Surg
Screening adults for type 2 diabetes: a review of the evidence for the U.S. Preventative Services Task Force
Ann Internal Med
A systematic review of the effectiveness of interventions to enhance the healing of chronic ulcers of the foot in diabetes
Diabetes Metab Res Rev
The diabetic foot: basic mechanisms of disease
J Bone Joint Surg Am (83(7)
A report from the international consensus on diagnosing and treating the infected diabetic foot
Diabetes Metab Res Rev
Diagnosing and treating diabetic foot infections
Diabetes Metab Res Rev
A systematic approach to diabetic foot infections
Adv Ther
Reducing plantar pressure in the neuropathic foot. A comparison of footwear
Diabetes Care
Total contact casts and removable cast walkers: mitigation of plantar pressure
J Am Podiatr Med Assoc
Effect of therapeutic footwear on reulceration in patients with diabetes: a randomized controlled trial
J Am Med Assoc
The effectiveness of an accommodative dressing in offloading pressure over areas of previous metatarsal head ulceration
Wounds
Effectiveness of diabetic therapeutic footwear in preventing reulceration
Diabetes Care
Efficacy and mechanism of orthotic devices to unload metatarsal heads in people with diabetes and history of plantar ulcers
Phys Ther
Recurrence and prevention of diabetic foot ulcers after total contact casting
Foot Ankle Int
Peak foot pressures influence the healing time of diabetic foot ulcers treated with total contact casts
J Rehabil Res Dev
Cited by (18)
The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study
2019, Journal of Clinical and Translational EndocrinologyCitation Excerpt :However only 4% of the treated patients were deemed to have deformities requiring extensor tenotomies, and in none of the four patients with recurrence of ulcers were extensor tenotomies deemed necessary. Transfer lesions were the most prevalent complications in this study and are known complications to tenotomy [11,12]. In our study 24% incurred transfer lesions.
Vascularized Pedicled Fibula Onlay Bone Graft Augmentation for Complicated Tibiotalocalcaneal Arthrodesis With Retrograde Intramedullary Nail Fixation: A Case Series
2016, Journal of Foot and Ankle SurgeryCitation Excerpt :The initial operative intervention begins with harvesting of bone marrow aspirate/graft from either the proximal tibia or lateral calcaneus (38). Soft tissue releases, most commonly involving percutaneous tendo-Achilles lengthening (39), posterior tibial tendon recession/lengthening (40), peroneus longus to peroneus brevis transfer (41), tarsal tunnel decompression, and/or percutaneous flexor toe tenotomies (42), are then performed as clinically warranted. If present, previous lateral hindfoot/ankle skin incisions are incised with additional length proximally and distally to minimize tension on the soft tissue envelope during bone preparation.
Surgical off-loading of the diabetic foot
2010, Journal of Vascular SurgeryCitation Excerpt :All patients healed with no significant complications noted. Although the methodologic quality of both studies was poor, their results support the ability of a percutaneous flexor tenotomy of the hallux and lesser toes to heal neuropathic toe ulceration secondary to toe contracture in persons with diabetes.47 A rigid hammer toe is best treated with an arthroplasty at the level of the distal or proximal interphalangeal joint.
Flexortenotomi med kanyl i tå vid diabetes - Enkelt och säkert
2021, LakartidningenPrevention of foot ulcers in the at-risk patient with diabetes: a systematic review
2020, Diabetes/Metabolism Research and ReviewsLesser toes deformities: A percutaneous approach
2020, Techniques in Foot and Ankle Surgery
Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.
Financial Disclosure: None reported.
Conflict of Interest: None reported.