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dc.contributor.author
Schöni, Madlaina
dc.contributor.author
Waibel, Felix W.A.
dc.contributor.author
Bauer, David
dc.contributor.author
Götschi, Tobias
dc.contributor.author
Böni, Thomas
dc.contributor.author
Berli, Martin C.
dc.date.accessioned
2021-03-22T11:43:49Z
dc.date.available
2020-04-23T02:30:50Z
dc.date.available
2020-04-23T09:41:43Z
dc.date.available
2021-03-22T11:43:49Z
dc.date.issued
2020-04
dc.identifier.issn
0936-8051
dc.identifier.issn
0344-8444
dc.identifier.issn
1434-3916
dc.identifier.other
10.1007/s00402-020-03441-3
en_US
dc.identifier.uri
http://hdl.handle.net/20.500.11850/411162
dc.description.abstract
Introduction Internal partial forefoot amputation (IPFA) is a treatment option for osteomyelitis and refractory and recurrent chronic ulcers of the forefoot. The aim of our study was to assess the healing rate of chronic ulcers, risk of ulcer recurrence at the same area or re-ulceration at a different area and revision rate in patients treated with IPFA. Materials and methods All patients who underwent IPFA of a phalanx and/or metatarsal head and/or sesamoids at our institution because of chronic ulceration of the forefoot and/or osteomyelitis from 2004 to 2014 were included. Information about patient characteristics, ulcer healing, new ulcer occurrence, and revision surgery were collected. Kaplan–Meier survival curves were plotted for new ulcer occurrence and revision surgery. Results A total of 102 patients were included (108 operated feet). 55.6% of our patients had diabetes. In 44 cases, an IPFA of a phalanx was performed, in 60 cases a metatarsal head resection and in 4 cases an isolated resection of sesamoids. The mean follow-up was 40.9 months. 91.2% of ulcers healed after a mean period of 1.3 months. In 56 feet (51.9%), a new ulcer occurred: 11 feet (10.2%) had an ulcer in the same area as initially (= ulcer recurrence), in 45 feet (41.7%) the ulcer was localized elsewhere (= re-ulceration). Revision surgery was necessary in 39 feet (36.1%). Only one major amputation and five complete transmetatarsal forefoot amputations were necessary during the follow-up period. Thus, the major amputation rate was 0.9%, and the minor amputation rate on the same ray was 13.9%. Conclusions IPFA is a valuable treatment of chronic ulcers of the forefoot. However, new ulceration is a frequent event following this type of surgery. Our results are consistent with the reported re-ulceration rate after conservative treatment of diabetic foot ulcers. The number of major amputations is low after IPFA. Level of evidence Retrospective Case Series Study (Level IV).
en_US
dc.language.iso
en
en_US
dc.publisher
Springer
en_US
dc.subject
Internal partial forefoot amputation
en_US
dc.subject
Diabetes mellitus
en_US
dc.subject
Foot ulcer
en_US
dc.subject
Ulcer recurrence
en_US
dc.subject
Re-ulceration
en_US
dc.subject
Revision
en_US
dc.title
Long-term results after internal partial forefoot amputation (resection): a retrospective analysis
en_US
dc.type
Journal Article
dc.date.published
2020-04-07
ethz.journal.title
Archives of Orthopaedic and Trauma Surgery
ethz.journal.volume
141
en_US
ethz.journal.issue
4
en_US
ethz.journal.abbreviated
Arch Orthop Trauma Surg
ethz.pages.start
543
en_US
ethz.pages.end
554
en_US
ethz.identifier.wos
ethz.identifier.scopus
ethz.publication.place
Berlin
en_US
ethz.publication.status
published
en_US
ethz.date.deposited
2020-04-23T02:30:54Z
ethz.source
WOS
ethz.eth
yes
en_US
ethz.availability
Metadata only
en_US
ethz.rosetta.installDate
2021-03-22T11:44:00Z
ethz.rosetta.lastUpdated
2021-03-22T11:44:00Z
ethz.rosetta.versionExported
true
ethz.COinS
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