| Summary: | Objective: Approximately 80% of diabetic foot wounds occur in the front foot. Most of these wounds are associated with bone and joint involvement. Toe amputations and ray amputations are the most frequently performed surgical interventions for lesions limited to the front foot. Many diabetic patients refuse surgery despite having advanced deformities that may cause serious injuries. In regard of such patients, we devised a new alternative surgical procedure that maintains the appearance of the toe and is not perceived by patients as amputation.
Material and Methods: Seventy-six toe lesions of 66 diabetic patients were treated with the new surgical approach between 01-0-2004 and 08-11-2012. Of these patients 50 were male and 16 were female. Their mean age was 60.4 years, and mean duration of diabetes was 16.6 years.
Results: The mean follow-up period was 26.4 (range, 12.0–71.4) months. In 47 patients, the surgical closure healed by primary intention (81%). Dehiscence occurred in 11 patients (19%). Infection of the surgical wound developed in four patients (6.9%). Ulcer relapse occurred in three patients (5.1%). In six patients (10.3%), an ulcer developed in the contralateral foot. In the long-term follow-up, 66 toes of 58 patients were seen to recover in the same or almost same length and width as the other non-deformed toes.
Conclusion: Removal of the involved bone and other involved tissues while preserving the skin and other healthy tissues to reconstruct an acceptable new toe is possible using this new technique.
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