Resection of metatarsal head for treatment of resistant non ischaemic neuropathic diabetic foot ulcers: a prospective comparative study of 40 patients

ABSTRACT

The aim of my study is to assess the surgical technique of metatarsal head excision as an initial step in the treatment of non ischaemic neuropathic trophic foot ulcers of diabetic patients and to compare it with the non operative conservative treatment lines as regard rate of wound healing, postoperative complications and the development of new or recurrent ulcers and the incidence of major amputations during the period of the study. Forty diabetic patients with non ischaemic neuropathic foot ulcers were enrolled during this study. The patients were divided into 2 equal groups. All the patients were assessed clinically, full laboratory investigations, all had palpable peripheral pulses and clinically non infected trophic ulcers on the sole of the foot. Group A patients weod of 14.6 months which is statistically significantly less than group [B] patients at a percentage 33% with a mean fellow up period of 5 months. Metatarsal head excision for neuropathic diabetic foot ulcer would be advocated as a method of treatment as this technique is safe, facilitates closure of the lesion, helps to control infection and prevents countless and costly amputations