Evidence map›Paper›PMID 38497521›Full record

ArticleFoot & ankle international2024

Second Metatarsal Length and Transfer Ulcers After First Metatarsal Amputation in Diabetic Foot Infections.

Nicola A Cavalcanti, Katharina Martini, Tobias Götschi, Nicola Krähenbühl, Madlaina Schöni, Felix W A Waibel

Open access · hybridAbstract read
In one paragraph

Article in Foot & ankle international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Nicola A CavalcantiDepartment of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.ORCID 0009-0006-0674-0773
Katharina MartiniDepartment of Radiology, Balgrist University Hospital, Zurich, Switzerland.ORCID 0000-0002-2638-6832
Tobias GötschiDepartment of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
Nicola KrähenbühlDepartment of Orthopaedics, University Hospital Basel, Basel, Switzerland.ORCID 0000-0003-0526-3515
Madlaina SchöniDepartment of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.ORCID 0000-0002-3688-2223
Felix W A WaibelDepartment of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.ORCID 0000-0003-3991-8743
Universitätsklinik Balgrist · CHETH Zurich · CHUniversity Hospital of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPlantar transfer ulcers (TUs) underneath the second metatarsal head are frequent after first metatarsal ray amputations due to diabetic foot infections. Whether the second metatarsal length (2ML) is associated with TU occurrence in these patients is unclear. This study evaluated whether 2ML is associated with TU occurrence after first-ray amputations and whether ulcer-free survival is shorter in patients with "excess" 2ML.

methodsForty-two patients with a mean age of 67 (range 33-93) years, diabetes, and first metatarsal ray amputation (first amputation at the affected foot) were included. Two independent readers measured the 2ML using the Coughlin method. A protrusion of more than 4.0 mm of the second metatarsal was defined as "excess" 2ML. The effect of 2ML on ulcer occurrence was analyzed using a multivariate Cox regression model. A Kaplan-Meier curve for TU-free survival was constructed comparing the 2 groups of "normal" (n = 21) and "excess" 2ML (n = 21).

resultsInterrater reliability was excellent. TUs underneath the second metatarsal occurred in 15 (36%) patients. In agreement with our hypothesis, 2ML was nonsignificantly different in patients with TUs, recording a mean of 5.3 (SD 2.5) mm, compared to patients without 4.0 (SD 2.3) mm (hazard ratio [HR] 1.12, 95% CI 0.89-1.41), whereas insulin dependence was associated with ulcer occurrence (HR 0.33, 95% CI 0.11-0.99).

conclusionIn our relatively small study population with a cutoff level of 4 mm for excess 2ML, ulcer-free survival was similar in patients with "normal" and "excess" 2ML. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Indexed as

Amputation, SurgicalDiabetic FootMetatarsal BonesAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective Studiesdiabetic foot infectionsmetatarsal measurementsecond metatarsal lengthtransfer ulcers

Identifiers

PMID38497521
PMCPMC11083743
OpenAlexW4392914359

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.