ArticleJournal of clinical orthopaedics and trauma2021
Medium-term outcomes of multi-disciplinary surgical management of non-ischemic diabetic heel ulcers.
Article in Journal of clinical orthopaedics and trauma, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Radical surgical treatment of calcaneal osteomyelitis: clinical characteristics and treatment efficacy based on a synthesis analysis of 364 reported cases.Journal of orthopaedic surgery and research · 2025Pooled it
- Clinical Effects of Thread-Dragging Therapy on Gangrene of Non-ischemic Diabetic Foot Ulcers.Chinese journal of integrative medicine · 2025Trial
- TLR4-paxillin-Rac1 signaling mediates LPS-induced dysregulation of keratinocyte function.iScience · 2026Article
- Article
- Impact of multidisciplinary management via special clinic for the outcome of diabetic foot disease: A prospective observational study.Journal of family medicine and primary care · 2024Article
- Article
- Investigation and management of diabetic foot osteomyelitis: An update for the foot and ankle orthopaedic surgeon.Journal of clinical orthopaedics and trauma · 2024Article
- Similarities and Differences Between Diabetes-Related and Trauma-Related Calcaneal Osteomyelitis: Comparisons Based on 681 Reported Cases.Infection and drug resistance · 2023Article
- Fluid management and strength postsimulated use of primary and secondary dressings for treating diabetic foot ulcers: Robotic phantom studies.International wound journal · 2022Article
- Tangshen Decoction Enhances Podocytes Autophagy to Relieve Diabetic Nephropathy through Modulation of p-AMPK/p-ULK1 Signaling.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Is there a need for diabetic foot orthopaedic surgery as a sub-specialty?Journal of clinical orthopaedics and trauma · 2021Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHeel ulcers in patients with peripheral neuropathy and diabetes pose a significant challenge to treating physicians. Infection spreading to the os calcis is associated with a poor prognosis. There is no consensus on which method of surgical treatments results in better outcomes. The aim of this study was to assess patients' survival, rate of ulcer healing following surgical treatment, along with limb salvage rate, time taken for healing, ulcer recurrence and patients' functional outcome after healing.
methodsWe studied 29 patients (20 men, 9 women) presenting with diabetic neuropathic heel ulcers (30 feet) and no critical limb ischemia, were managed surgically in our unit and followed-up for a minimum of 12 months. We assessed their clinical and functional outcomes within a mean follow-up period of 28 months (12-83).
results11 out of 29 patients died (38%) with mean duration of post op survival being 31months (range 4-70). 14 ulcers (50%) healed fully within a mean of 360 days (131-1676). Limb salvage was achieved in 29 feet (97%). Only 5 out of 17 patients with diabetic nephropathy (p value 0.016) and 9 out of 24 ulcers with calcaneal osteomyelitis (p value 0.044) achieved full ulcer healing. Ulcer recurrence rate was 36% (5/14) within 12 months of achieving ulcer healing. Six patients were able to return to independent walking in surgical shoes while 11 patients were mobilising using either a crutch or frame.
conclusionWhile excellent limb salvage can be anticipated from the outcome of surgically managed infected heel ulcers in patients with diabetes, complete healing can still be slow and unpredictable. Significant medical co-morbidities in these patients make them vulnerable to medium-term post-operative complication and survival.
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