The treatment of Diabetic Foot Ulcers by percutaneous metatarsal osteotomies: A prospective study

Background: Diabetic Foot Ulcers (DFUs) are present on about 15% of diabetic patients and still represent a challenge for orthopaedic surgeons. The aim of this prospective study was to analyse the functional and radiographic results of patients with DFUs treated by percutaneous metatarsal osteotomy. Materials and methods: 35 DFUs on 30 patients (mean age of 67 years) operated by the same surgeon were included in this study. All of the patients had peripheral neuropathy and a diagnosis of DM for a mean of 19 years. The mean diameter of the plantar ulcers was 163; 62 mm (50\u2013250), and the most frequent grade of the University of Texas score was IIIB (43%). The mean age of the ulcers was 10.3 months. Results: The mean healing time was 7.94 \ub1 4.04 weeks (4 to 17 wks) and all of the patients healed. We did not record cases of ulcer recurrence at a mean follow-up of 25 months (9 to 71). The mean AOFAS score before operating was 55 (42 to 71) and, at the last check-up, was 81 (64 to 100). We had a single complication: a skin infection of Streptococcus Agalactiae, treated with antibiotic therapy. Conclusions: Minimally Invasive metatarsal osteotomy is recommended for patients with forefoot plantar DFUs without any exception of the University of Texas Diabetic Wound Classification