Metatarsal head resection for diabetic foot ulcers
G. D. Griffiths and T. J. Wieman
Department of Surgery, University of Louisville, School of Medicine, KY 40292.
Twenty-five diabetic patients underwent 34 metatarsal head resections for
chronic neuropathic ulceration. All ulcers were located on the plantar
surface beneath the metatarsophalangeal joints. The ulcers had been present
for a mean of 9.0 +/- 7.8 months before operation, yet they healed in a
mean of 2.4 +/- 1.6 months postoperatively. None recurred during the mean
follow-up time of 13.8 +/- 11.0 months. Moderate peripheral vascular
disease, impaired renal function, and retinopathy did not affect the time
required for ulcer healing. There were two complications: one wound
infection and one hematoma. No extremities were lost, and none of the
patients suffered any long-term sequelae. We recommend metatarsal head
resection to achieve the healing of chronic diabetic foot ulcers under the
metatarsophalangeal joints.
