Tendon lengthening and fascia release for healing and preventing diabetic foot ulcers: a systematic review and meta-analysis

Excerpt

Diabetic foot ulcers have a devastating impact on an individual's health-related quality of life and functional status. Additionally, diabetic foot ulcers impose a significant economic burden on our health care systems as a result of complications such as infection, hospitalisation and amputation. The current gold standard treatment is total contact casting. However, the rate of ulcer recurrence is high indicating the need for more effective long-term treatment options. The aim of this study was to evaluate all literature investigating the effectiveness of Achilles tendon lengthening, gastrocnemius recession and selective plantar fascia release in healing and preventing diabetic foot ulcers. The primary outcome measures were time to healing of the ulcer, rate of ulcers healed, rate of ulcer recurrence and rate of transfer ulcers (i.e. new ulcer). The secondary outcome measures were complications and adverse events. …