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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.
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Figure 1.
Photographs of 57-year-old female patient with 12 year history of diabetes. (A) Patient had a second tip toe ulcer with claw toe deformity. (B, C) A percutaneous needle flexor tenotomy was performed while applying forceful extension of the interphalangeal joint to inducing bowstring of the flexor tendon. (D) The dressing gauze was adhered to adjacent toes while keeping elevation of the ulcerated toe.
Figure 2.
Photographs of 57-year-old female (A, B) and 61-year-old male (C, D) patients during follow-up. Patients had a second tip toe ulcer with claw toe deformity. (A, C) The wounds had dried up at one week after percutaneous flexor tenotomy. Small ulcer had healed completely (B), and the large ulcer had become smaller with formation of granulation tissue (D) at five weeks postoperatively. Note the toes had kept their straight position during follow-up.
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