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Complication rates in diabetics with first metatarsophalangeal joint arthrodesis

BACKGROUND: First metatarsophalangeal joint (MTPJ) arthrodesis has been an effective surgical entity when indicated, but a range of severe to mild complications can occur from this procedure. Patients with diabetes mellitus have an increased risk in surgical complications, most commonly associated w...

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Autores principales: Anderson, John J., Hansen, Myron, Rowe, Gregory Paul, Swayzee, Zflan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074606/
https://www.ncbi.nlm.nih.gov/pubmed/24987496
http://dx.doi.org/10.3402/dfa.v5.24649
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author Anderson, John J.
Hansen, Myron
Rowe, Gregory Paul
Swayzee, Zflan
author_facet Anderson, John J.
Hansen, Myron
Rowe, Gregory Paul
Swayzee, Zflan
author_sort Anderson, John J.
collection PubMed
description BACKGROUND: First metatarsophalangeal joint (MTPJ) arthrodesis has been an effective surgical entity when indicated, but a range of severe to mild complications can occur from this procedure. Patients with diabetes mellitus have an increased risk in surgical complications, most commonly associated with soft tissue and bone healing, when compared to non-diabetic patients. The purpose of this study was to evaluate the complication rates of first MTPJ arthrodesis in diabetic patients and compare them to the existing complication rates for the procedure. METHODS: A retrospective chart review was done on 76 diabetic patients, from June 2002 to August 2012. Thirty-two males and 44 females were included in the study. The authors evaluated many variables that could impact postoperative complications, including age, gender, bone graft incorporation, hemoglobin A1c, tobacco use, body mass index, peripheral neuropathy, hallux extensus, hallux interphalangeal arthritis, and rheumatoid arthritis, and compared them with the complication findings. Patient follow-up was no less than 24 months. RESULTS: Overall, approximately two-thirds of the patients had no complications and 35.5% of patients had at least one mild or moderate complication. Of the non-union and mal-union complications, 80 and 70% had peripheral neuropathy, respectively. One hundred percent of the patients that had mal-positions or hardware failure also had peripheral neuropathy. No severe complications were seen during follow-up. Only two of the moderate complications needed revisions, and the rest of those with moderate complications were asymptomatic. CONCLUSION: In conclusion, first MTPJ arthrodesis is overall an effective and beneficial procedure in patients with diabetes mellitus. Diabetic patients with peripheral neuropathy have an increased risk for mild and moderate complications.
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spelling pubmed-40746062014-07-01 Complication rates in diabetics with first metatarsophalangeal joint arthrodesis Anderson, John J. Hansen, Myron Rowe, Gregory Paul Swayzee, Zflan Diabet Foot Ankle Clinical Research Article BACKGROUND: First metatarsophalangeal joint (MTPJ) arthrodesis has been an effective surgical entity when indicated, but a range of severe to mild complications can occur from this procedure. Patients with diabetes mellitus have an increased risk in surgical complications, most commonly associated with soft tissue and bone healing, when compared to non-diabetic patients. The purpose of this study was to evaluate the complication rates of first MTPJ arthrodesis in diabetic patients and compare them to the existing complication rates for the procedure. METHODS: A retrospective chart review was done on 76 diabetic patients, from June 2002 to August 2012. Thirty-two males and 44 females were included in the study. The authors evaluated many variables that could impact postoperative complications, including age, gender, bone graft incorporation, hemoglobin A1c, tobacco use, body mass index, peripheral neuropathy, hallux extensus, hallux interphalangeal arthritis, and rheumatoid arthritis, and compared them with the complication findings. Patient follow-up was no less than 24 months. RESULTS: Overall, approximately two-thirds of the patients had no complications and 35.5% of patients had at least one mild or moderate complication. Of the non-union and mal-union complications, 80 and 70% had peripheral neuropathy, respectively. One hundred percent of the patients that had mal-positions or hardware failure also had peripheral neuropathy. No severe complications were seen during follow-up. Only two of the moderate complications needed revisions, and the rest of those with moderate complications were asymptomatic. CONCLUSION: In conclusion, first MTPJ arthrodesis is overall an effective and beneficial procedure in patients with diabetes mellitus. Diabetic patients with peripheral neuropathy have an increased risk for mild and moderate complications. Co-Action Publishing 2014-06-27 /pmc/articles/PMC4074606/ /pubmed/24987496 http://dx.doi.org/10.3402/dfa.v5.24649 Text en © 2014 John J. Anderson et al. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Anderson, John J.
Hansen, Myron
Rowe, Gregory Paul
Swayzee, Zflan
Complication rates in diabetics with first metatarsophalangeal joint arthrodesis
title Complication rates in diabetics with first metatarsophalangeal joint arthrodesis
title_full Complication rates in diabetics with first metatarsophalangeal joint arthrodesis
title_fullStr Complication rates in diabetics with first metatarsophalangeal joint arthrodesis
title_full_unstemmed Complication rates in diabetics with first metatarsophalangeal joint arthrodesis
title_short Complication rates in diabetics with first metatarsophalangeal joint arthrodesis
title_sort complication rates in diabetics with first metatarsophalangeal joint arthrodesis
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074606/
https://www.ncbi.nlm.nih.gov/pubmed/24987496
http://dx.doi.org/10.3402/dfa.v5.24649
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