Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 25166
MINOR AMPUTATION SUCCESSFUL IN PATIENTS WITH DIABETES MELLITUS
AND SEVERE FOOT ULCERS THREATENING THE SURVIVAL OF THE FOOT
Hedvig SVENSSON, Jan LARSSON, Jan APELQVIST, Magnus ENEROTH
Department of Orthopaedics, Skane University Hospital, Malmö, Lund (SWEDEN)
Background: The principal aim of a minor amputation is to avoid a major amputation.
Minor amputations are performed on many diabetic patients but little is known about
the outcome. The aim of this study was to analyse the outcome of minor amputations
in patients with diabetes and severe foot ulcers threatening the survival of the foot.
Patients and Methods: All diabetic patients in a defined population undergoing minor
amputation between 1982 and 2006 were investigated according to a standardised
protocol and were followed until final outcome (healing or death). 410 consecutive
amputations in 309 patients with a median age of 73 (32-93) years were identified.
Results: In 94%, deep infection and/or gangrene was present at amputation. Severe
peripheral vascular disease or critical limb ischemia was present in 61% of
amputations. Almost two thirds (64%) of the amputations healed at a level below the
ankle, 17% healed after a re-amputation above the ankle and in 19% of amputations
the patient died before healing was achieved. In surviving patients 79% healed below
the ankle. Median healing time for those who healed below the ankle was 26 (2-250)
weeks. 21% of amputations had a re-amputation above the ankle. Conclusion: The
goal of avoiding major amputation was achieved in almost two thirds of minor
amputations, in patients with diabetes and severe foot ulcers threatening the survival
of the foot. This indicates that minor amputations in these patients are worth while.
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