The Diabetic Foot: A Surgical Perspective
Diabetes causes neuropathy (weakness, numbness and pain due to nerve damage) and decreased circulation of blood in the legs. This can lead to minor cuts and blisters going unnoticed, which in turn leads to severe ulceration, raised plantar pressures and deformities of the toes and feet. Called ‘Diabetic Foot’, this is a potentially life-threating problem as infection-causing bacteria can enter these wounds easily, especially in immunocompromised (low or impaired immunity system) patients.
In many cases, the only solution for this condition can be amputation. However, even if a person walks using the best of prosthesis, the mortality rate at 5 years after unilateral, below-knee amputation is 50%. The mortality rate is 50% at 3 years in those who have undergone above-knee amputation.
Also, when the blood supply to the foot is compromised, the heart also gets involved. Studies have revealed that even with the best of prosthesis, the cardiac strain is increases 15%, which in turn can lead to cardiac failure over a period of time.
The number of diabetic amputees has been increasing steadily in India. A very unfortunate thing to happen, this is mainly because of inaccessibility to expert podiatric services; lack of multi-disciplinary team approach in treatment; unavailability of diabetic orthotics; socio-economic factors like walking barefoot; use of wrong footwear and most importantly, lack of awareness of the seriousness of diabetic foot problems – both among patients as well doctors.
The department of Podiatric Surgery at Aster Medcity provides specialised care for comprehensive management diabetic lower limb surgical problems, with focus on limb salavaging. The multidisciplinary approach enables efficient and effective management of the problem, which ensures the best possible outcome.
We also provide expert treatment for extensive lower-limb necrotizing fasciitis; various types of foot infections and Charcot’s foot (with marked destruction of the foot and ankle bones/ grossly deformed toes and foot).
Surgical correction for the diabetic foot and ankle deformity has evolved phenomenally and is now considered as the best way to correct foot deformities caused due to prolonged diabetes. A highly advanced procedure, re-shaping of deformed foot or toes eliminates the need for amputation in most cases.
In order to avoid the serious complications of pin-tract infections, wire breakage and others associated with the application of external fixators in diabetic patients, we have devised a novel method of for foot and ankle stabilisation called ‘The Sling Technique’ (for reconstruction of Charcot’s foot and ankle). We also replace foot and ankle bones destroyed by osteomyelitis or Charcot’s osteoarthropathy using prosthesis made of ‘Polymethyl Methacrilate’. With highly specialised treatment methods, innovative techniques and multidiscplinary approach, we have made the limb salvage rates comprable to the best podiatry centres across the world.