Analysis of the Risk Factors for Lower Extremity Amputation due to Diabetic Foot Complications / 대한족부족관절학회지

PURPOSE: To evaluate the possible risk factors of lower extremity amputations in diabetic foot patients. MATERIALS AND METHODS: The study is based on 37 patients who received lower extremity amputations from April, 1997 to February 2005 due to diabetic foot complications with at least 1 year follow up. As for the control group, 49 diabetes patients who had been treated at the endocrinology department for at least 1 year without any diabetic foot complication were evaluated. As for the possible risk factors, age, gender, duration of diabetes mellitus, body mass index, Hb A1c, blood glucose level, total cholesterol, s-creatinine, C-peptide, smoking, alcohol, hypertension, cardiovascular disease, CVA, retinopathy and neuropathy were investigated. RESULTS: Among the possible risk factors evaluated, age, Hb A1c, smoking, neuropathy and blood glucose level factors showed statistically significant difference between the diabetic amputation and the control group. CONCLUSION: In reducing the risk of the lower extremity amputations in the diabetic patients due to diabetic foot complications, strict control of blood glucose level and cessation of smoking were found to be utmost important.

Lower Extremity Amputations for the Diabetic Foot Complication / 대한족부족관절학회지

PURPOSE: To evaluate the clinical manifestations, the patterns and the functional outcome of the amputations due to the diabetic foot complications. MATERIALS AND METHODS: Fifty patients (50 feet) of diabetic foot amputations were followed for more than 1 year. The mean age was 62.5 years, and the mean follow-up period was 46 months. Retrospective analysis was performed using chart review and interview with the patients. The outcome was assessed with modified AOFAS scale. RESULTS: The diabetic foot lesions were infection in 45 feet, gangrene in 35 feet and ulcer in 15 feet. Toe amputation was most commonly performed procedure (23 cases) followed by below knee and ray amputation. Postoperative modified AOFAS score was average 51.5 points, and 94% were satisfied with outcome. Minor amputations showed better outcome than the major amputations. CONCLUSION: Overall postoperative functional outcome was encouraging with high patient satisfaction rate (94%). Better outcome was obtained with the minor amputations.

Statistical Analysis of the Patellar Thickness in Adults by MRI / 대한정형외과학회잡지

PURPOSE: To provide information on the thickness of the patella in Korean adults and to provide a standard for the selection of a proper patella implant in total knee arthroplasty. MATERIALS AND METHODS: From October 2002 to June 2004, the patellar thickness was measured by MRI in 165 knees. The mean age of the patients was 29 years (20-39 years). Patients with either patellar fractures or deformities were excluded. Of the knees included in this study, 54 knees had meniscal injuries, 53 had cruciate ligament injuries, 24 had knee contusions, and 17 had other disorders. The remaining 17 knees were normal. The measurements were taken in the axial and sagittal images of the MRI scans. The maximum distance in millimeter between the anterior cortex of the patella and the surface of the articular cartilage was measured to the first decimal place. The relationship between the patellar thickness and gender, weight and height was also analyzed. RESULTS: The average patellar thickness on the axial image was 23.8 (SD 1.4) mm in males and 21.7 (SD 1.4) mm in females. The measurement estimated in the axial image was not significantly different from that in the sagittal image. The patellar thickness in males was significantly thicker than in females (p<0.01). There was a significant correlation between the patellar thickness and both the body weight and height (p<0.01). CONCLUSION: The average patellar thickness in Korean adults was 23.8 mm in males and 21.7 mm in females. The patella was thicker in males than in females. Moreover, the patellar thickness was proportional to the height and weight of each individual.