Outcomes of Keller Gap Arthroplasty for Plantar Hallux Interphalangeal Joint Ulcers in Patients With Diabetes Mellitus
Background: Hallux ulcers are known for their recurrence and associated risk for future amputations. Traditional nonsurgical external offloading methods have poor compliance rates, and the data is sparse on surgical offloading of hallux ulcers. We performed this study to analyze the outcomes of Kell...
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| Veröffentlicht in: | Foot & ankle international 2023-03, Vol.44 (3), p.192-199 |
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| creator | Periasamy, Madhu Muthukumar, Vamseedharan Mali Reddy, Radhika Asokan, Kumanan Sabapathy, S. Raja |
| description | Background:
Hallux ulcers are known for their recurrence and associated risk for future amputations. Traditional nonsurgical external offloading methods have poor compliance rates, and the data is sparse on surgical offloading of hallux ulcers. We performed this study to analyze the outcomes of Keller excision gap arthroplasty of the first metatarsophalangeal joint in patients with a neuropathic plantar hallux interphalangeal joint (IPJ) ulcer in patients with diabetes mellitus.
Methods:
A retrospective study of 105 diabetic patients with a plantar hallux IPJ ulcer who underwent a Keller excision gap arthroplasty between December 2014 and June 2020 was done. A total of 122 great toes had been operated upon for hallux IPJ ulcers. We studied the long-term wound healing rates from patient records and then did a prospective survey of the postreview period.
Results:
All the hallux IPJ ulcers healed well in the immediate postoperative period. Six patients reported a recurrence of the ulcer at the original site during a mean follow-up period of 30 months. For these 6 patients, the mean time to recurrence of ulcer after operation was 2.5 years.
Conclusion:
At an average of 30 months, we found the Keller gap arthroplasty for treatment of noninfected and nonischemic diabetic foot hallux IPJ ulcers was associated with an ulcer recurrence rate of 5%.
Level of Evidence:
Level IV, cohort study. |
| doi_str_mv | 10.1177/10711007231152883 |
| format | Article |
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Hallux ulcers are known for their recurrence and associated risk for future amputations. Traditional nonsurgical external offloading methods have poor compliance rates, and the data is sparse on surgical offloading of hallux ulcers. We performed this study to analyze the outcomes of Keller excision gap arthroplasty of the first metatarsophalangeal joint in patients with a neuropathic plantar hallux interphalangeal joint (IPJ) ulcer in patients with diabetes mellitus.
Methods:
A retrospective study of 105 diabetic patients with a plantar hallux IPJ ulcer who underwent a Keller excision gap arthroplasty between December 2014 and June 2020 was done. A total of 122 great toes had been operated upon for hallux IPJ ulcers. We studied the long-term wound healing rates from patient records and then did a prospective survey of the postreview period.
Results:
All the hallux IPJ ulcers healed well in the immediate postoperative period. Six patients reported a recurrence of the ulcer at the original site during a mean follow-up period of 30 months. For these 6 patients, the mean time to recurrence of ulcer after operation was 2.5 years.
Conclusion:
At an average of 30 months, we found the Keller gap arthroplasty for treatment of noninfected and nonischemic diabetic foot hallux IPJ ulcers was associated with an ulcer recurrence rate of 5%.
Level of Evidence:
Level IV, cohort study.</description><identifier>ISSN: 1071-1007</identifier><identifier>EISSN: 1944-7876</identifier><identifier>DOI: 10.1177/10711007231152883</identifier><identifier>PMID: 36760022</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Arthroplasty - methods ; Cohort Studies ; Diabetes Mellitus ; Diabetic Foot - surgery ; Follow-Up Studies ; Foot Ulcer ; Hallux - surgery ; Humans ; Metatarsophalangeal Joint - surgery ; Prospective Studies ; Retrospective Studies ; Ulcer - complications ; Ulcer - surgery</subject><ispartof>Foot & ankle international, 2023-03, Vol.44 (3), p.192-199</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-9cff0994994592c201989fddada3a5f03ab55d26d986a122770cb0c80e8e94833</citedby><cites>FETCH-LOGICAL-c383t-9cff0994994592c201989fddada3a5f03ab55d26d986a122770cb0c80e8e94833</cites><orcidid>0000-0002-0456-8555</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/10711007231152883$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/10711007231152883$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36760022$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Periasamy, Madhu</creatorcontrib><creatorcontrib>Muthukumar, Vamseedharan</creatorcontrib><creatorcontrib>Mali Reddy, Radhika</creatorcontrib><creatorcontrib>Asokan, Kumanan</creatorcontrib><creatorcontrib>Sabapathy, S. Raja</creatorcontrib><title>Outcomes of Keller Gap Arthroplasty for Plantar Hallux Interphalangeal Joint Ulcers in Patients With Diabetes Mellitus</title><title>Foot & ankle international</title><addtitle>Foot Ankle Int</addtitle><description>Background:
Hallux ulcers are known for their recurrence and associated risk for future amputations. Traditional nonsurgical external offloading methods have poor compliance rates, and the data is sparse on surgical offloading of hallux ulcers. We performed this study to analyze the outcomes of Keller excision gap arthroplasty of the first metatarsophalangeal joint in patients with a neuropathic plantar hallux interphalangeal joint (IPJ) ulcer in patients with diabetes mellitus.
Methods:
A retrospective study of 105 diabetic patients with a plantar hallux IPJ ulcer who underwent a Keller excision gap arthroplasty between December 2014 and June 2020 was done. A total of 122 great toes had been operated upon for hallux IPJ ulcers. We studied the long-term wound healing rates from patient records and then did a prospective survey of the postreview period.
Results:
All the hallux IPJ ulcers healed well in the immediate postoperative period. Six patients reported a recurrence of the ulcer at the original site during a mean follow-up period of 30 months. For these 6 patients, the mean time to recurrence of ulcer after operation was 2.5 years.
Conclusion:
At an average of 30 months, we found the Keller gap arthroplasty for treatment of noninfected and nonischemic diabetic foot hallux IPJ ulcers was associated with an ulcer recurrence rate of 5%.
Level of Evidence:
Level IV, cohort study.</description><subject>Arthroplasty - methods</subject><subject>Cohort Studies</subject><subject>Diabetes Mellitus</subject><subject>Diabetic Foot - surgery</subject><subject>Follow-Up Studies</subject><subject>Foot Ulcer</subject><subject>Hallux - surgery</subject><subject>Humans</subject><subject>Metatarsophalangeal Joint - surgery</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Ulcer - complications</subject><subject>Ulcer - surgery</subject><issn>1071-1007</issn><issn>1944-7876</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kElPwzAQhS0EYin8AC7IRy4BL0lsHxFLWxbBAcQxmjpOG-TGwXYQ_HtctXBBQrJka_y9NzMPoWNKzigV4pwSQSkhgnFKCyYl30L7VOV5JqQot9M7_WcrYA8dhPBGCBWcql20x0tREsLYPvp4HKJ2SxOwa_CdsdZ4PIYeX_i48K63EOIXbpzHTxa6CB5PwNrhE0-7aHy_gFSdG7D41rVdxC9WGx9w2-EniK3pYsCvbVzgqxZmJqYmD6lDG4dwiHYasMEcbe4Rerm5fr6cZPeP4-nlxX2mueQxU7ppiFJ5OoVimhGqpGrqGmrgUDSEw6woalbWSpZAGROC6BnRkhhpVC45H6HTtW_v3ftgQqyWbdBpCOiMG0KVFEVJc5GThNI1qr0LwZum6n27BP9VUVKt4q7-xJ00Jxv7YbY09a_iJ98EnK2BAHNTvbnBd2ndfxy_AZZzh_c</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Periasamy, Madhu</creator><creator>Muthukumar, Vamseedharan</creator><creator>Mali Reddy, Radhika</creator><creator>Asokan, Kumanan</creator><creator>Sabapathy, S. Raja</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0456-8555</orcidid></search><sort><creationdate>202303</creationdate><title>Outcomes of Keller Gap Arthroplasty for Plantar Hallux Interphalangeal Joint Ulcers in Patients With Diabetes Mellitus</title><author>Periasamy, Madhu ; Muthukumar, Vamseedharan ; Mali Reddy, Radhika ; Asokan, Kumanan ; Sabapathy, S. Raja</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-9cff0994994592c201989fddada3a5f03ab55d26d986a122770cb0c80e8e94833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arthroplasty - methods</topic><topic>Cohort Studies</topic><topic>Diabetes Mellitus</topic><topic>Diabetic Foot - surgery</topic><topic>Follow-Up Studies</topic><topic>Foot Ulcer</topic><topic>Hallux - surgery</topic><topic>Humans</topic><topic>Metatarsophalangeal Joint - surgery</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Ulcer - complications</topic><topic>Ulcer - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Periasamy, Madhu</creatorcontrib><creatorcontrib>Muthukumar, Vamseedharan</creatorcontrib><creatorcontrib>Mali Reddy, Radhika</creatorcontrib><creatorcontrib>Asokan, Kumanan</creatorcontrib><creatorcontrib>Sabapathy, S. Raja</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Foot & ankle international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Periasamy, Madhu</au><au>Muthukumar, Vamseedharan</au><au>Mali Reddy, Radhika</au><au>Asokan, Kumanan</au><au>Sabapathy, S. Raja</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Keller Gap Arthroplasty for Plantar Hallux Interphalangeal Joint Ulcers in Patients With Diabetes Mellitus</atitle><jtitle>Foot & ankle international</jtitle><addtitle>Foot Ankle Int</addtitle><date>2023-03</date><risdate>2023</risdate><volume>44</volume><issue>3</issue><spage>192</spage><epage>199</epage><pages>192-199</pages><issn>1071-1007</issn><eissn>1944-7876</eissn><abstract>Background:
Hallux ulcers are known for their recurrence and associated risk for future amputations. Traditional nonsurgical external offloading methods have poor compliance rates, and the data is sparse on surgical offloading of hallux ulcers. We performed this study to analyze the outcomes of Keller excision gap arthroplasty of the first metatarsophalangeal joint in patients with a neuropathic plantar hallux interphalangeal joint (IPJ) ulcer in patients with diabetes mellitus.
Methods:
A retrospective study of 105 diabetic patients with a plantar hallux IPJ ulcer who underwent a Keller excision gap arthroplasty between December 2014 and June 2020 was done. A total of 122 great toes had been operated upon for hallux IPJ ulcers. We studied the long-term wound healing rates from patient records and then did a prospective survey of the postreview period.
Results:
All the hallux IPJ ulcers healed well in the immediate postoperative period. Six patients reported a recurrence of the ulcer at the original site during a mean follow-up period of 30 months. For these 6 patients, the mean time to recurrence of ulcer after operation was 2.5 years.
Conclusion:
At an average of 30 months, we found the Keller gap arthroplasty for treatment of noninfected and nonischemic diabetic foot hallux IPJ ulcers was associated with an ulcer recurrence rate of 5%.
Level of Evidence:
Level IV, cohort study.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>36760022</pmid><doi>10.1177/10711007231152883</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0456-8555</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Foot & ankle international, 2023-03, Vol.44 (3), p.192-199 |
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| language | eng |
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| source | SAGE Complete A-Z List; MEDLINE |
| subjects | Arthroplasty - methods Cohort Studies Diabetes Mellitus Diabetic Foot - surgery Follow-Up Studies Foot Ulcer Hallux - surgery Humans Metatarsophalangeal Joint - surgery Prospective Studies Retrospective Studies Ulcer - complications Ulcer - surgery |
| title | Outcomes of Keller Gap Arthroplasty for Plantar Hallux Interphalangeal Joint Ulcers in Patients With Diabetes Mellitus |
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