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Outpatient Percutaneous Flexor Tenotomy for Diabetic Claw Toe Deformity with Ulcer
J Korean Foot Ankle Soc 2018;22:151-155
Published online December 15, 2018;  https://doi.org/10.14193/jkfas.2018.22.4.151
© 2018 Korean Foot and Ankle Society

Dong-Hun Lee, Jin-Wha Chung

Department of Orthopedic Surgery, Bucheon St. Mary’s Hospital, College of Medicine, Catholic Universtiy of Korea, Bucheon, Korea
Correspondence to: Jin-Wha Chung
Department of Orthopedic Surgery, The Catholic University of Korea, Bucheon St. Mary’s Hospital, 327 Sosa-ro, Wonmi-gu, Bucheon 14647, Korea
Tel: 82-32-340-7034, Fax: 82-32-340-2671, E-mail: koreafoot@gmail.com
ORCID: https://orcid.org/0000-0002-4902-9133
Received October 15, 2018; Revised November 11, 2018; Accepted November 15, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers.
Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill.
Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy.
Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.
Keywords : Toes, Diabetic foot, Ulcer, Percutaneous tenotomy


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