Friday, February 8, 2019

Metatarsal Head Resection in Treatment of Neuropathic Diabetic Foot Ulcers

Forefoot Ulcers

                     Are more common ulcers found at the plantar aspect as non healing for prolonged duration.These patients are prone for recurrence as they are treated for the cause,namely surgical offloading , especially excision of metatarsal head , when compared to conservative mangement.


Non healing ulcer at forefoot
         
                    Patient is assesed for blood flow , using doppler. Foot  pressure analysis,so that offloading can be planned accordingly.




Metatarsal Head resection being done As the treatment of choice.

                      Through a ventral approach , vertical incision made over the MTPjoint of the desired toe.Head with neck is excised.Skin closed after securing hemostasis.


Plantar Ulcer excision and debridement Done.

                          Ulcer Debridement , callus excision done . Wound cavity packed with bulky betadine gauze dressing.


3 Months of post operative follow up .

                    After wound debridement , followed with regular dressing. Adviced diabetic foot wear, Tendoachilles Strength exercises.



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