Abstract:
BACKGROUND:Digital toe amputation is a relatively minor surgical procedure but there is a historical view that it is the "first stage in a predictable clinical course" leading to eventual limb loss. There is a paucity of contemporaneous data on the long-term outcomes of patients undergoing toe amputation. We aim to study the experience from our institution, focussing on the risk factors for progression to future limb loss, by conducting a retrospective review of our practice. METHODS:Sixty-three patients undergoing toe amputation within our institution were identified and the clinical notes retrospectively reviewed. A database of vascular risk factors and co-morbidity was constructed and correlation with future limb loss was analysed with Chi-squared testing and a logistic regression model. RESULTS:Sixty-three patients with a mean age of 69 (IQR 62-76.5) years were identified. Thirty-five (55.6%) of these patients went on to have a further surgical amputation; 22 major amputations (16 below-knee and 6 above-knee amputations) and 23 minor amputations were performed in total. Forty three (68.3%) patients had diabetes and 31 (49.2%) patients had one or more revascularisation procedures undertaken. There was a significant correlation between patients who did not have diabetes and future limb loss (Chi-squared=4.31, p=0.038), however no other identified risk factor predicted the need for major amputation. CONCLUSION:Toe amputation is a significant predictor of future limb loss. Our study identified that patients with diabetes are significantly less likely to progress to further limb loss than those with the disease. We hypothesise that this difference is due to the more intensive, multi-disciplinary foot care follow-up that diabetic patients receive. These results highlight the significance of toe amputation and contribute to the evidence for a more intensive out-patient service for these high risk patients.
journal_name
J Diabetes Complicationsjournal_title
Journal of diabetes and its complicationsauthors
Griffin KJ,Rashid TS,Bailey MA,Bird SA,Bridge K,Scott JDdoi
10.1016/j.jdiacomp.2012.03.003subject
Has Abstractpub_date
2012-05-01 00:00:00pages
251-4issue
3eissn
1056-8727issn
1873-460Xpii
S1056-8727(12)00016-5journal_volume
26pub_type
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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abstract::Diabetes mellitus (DM) is a metabolic disorder of glucose homeostasis caused by insufficient secretion or inadequate action of insulin. Nowadays, the increased morbidity of DM is a worldwide issue. Pancreatic beta cell death plays a key role in the progress of DM, especially Type 1 diabetes (T1D). Traditional biomarke...
journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,评审
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 临床试验,杂志文章
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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