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-
1.
Apelqvist J, Larsson J: What is the most effective way to reduce incidence of amputation in the diabetic foot? Diabetes Metab Res Rev 16: 75, 2000.
-
2.
Tentelouris N, Al-Sabbagh S, Walker MG, et al: Mortality in diabetic and nondiabetic patients after amputations performed from 1990 to 1995. Diabetes Care 27: 1598, 2004.
-
3.
Grunfeld C: Diabetic foot ulcers: etiology, treatment, and preventation. Adv Intern Med 37: 103, 1991.
-
4.
Lipsky BA: Diabetic foot infections: pathophysiology, diagnosis, and treatment. Int J Dermatol 30: 560, 1991.
-
5.
Reiber GE, Lipsky BA, Gibbons GW: The burden of diabetic foot ulcers. Am J Surg 176: 5, 1998.
-
6.
Moulik P, Mtonga R, Gill GV: Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care 26: 491, 2003.
-
7.
Joseph WS: Treatment of lower extremity infections in diabetics. Drugs 42: 984, 1991.
-
8.
Ramsey SD, Newton K, Blough D, et al: Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care 22: 382, 1999.
-
9.
Lipsky BA: Osteomyelitis of the foot in diabetic patients. Clin Infect Dis 25: 1318, 1997.
-
10.
Tomas MB, Patel M, Marwin SE, et al: The diabetic foot. Br J Radiol 73: 443, 2000.
-
11.
Aksoy DY, Gurlek A, Cetinkaya Y et al: Change in the amputation profile in diabetic foot in a tertiary reference center: efficacy of team working. Exp Clin Endocrinol Diabetes 112: 526, 2004.
-
12.
Yorgancigil H, Benli T, Heybeli, N, et al: Diyabetik Ayakta Amputasyon XVII. Ulusal Ortopedi ve Travmatoloji Kongresi, Antalya, 2001, Kongre Kitabı, Cilt 1: 158, 2001.
-
13.
Tükenmez M, Çekin T, Karataş Ç et al: Diabetik Ayakta Alt Ekstremite Amputasyonları. J Faculty Med Cumhuriyet University 27: 100, 2005.
-
14.
Levin MH: Preventing amputation in the patient with diabetes. Diabetes Care 18: 1383, 1995.
-
15.
Young MJ, Veves A, Boulton AJ: The diabetic foot: Aetiopathogenesis and Management. Diab Metab Rev 9: 109, 1993.
Is Scintigraphy a Guideline Method in Determining Amputation Levels in Diabetic Foot?
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Background
In this study, we aimed to evaluate the potential use of a 3-phase bone scintigraphy method to determine the level of amputation on treatment cost, morbidity and mortality, reamputation rates, and the duration of hospitalization in diabetic foot.
Methods
Thirty patients who were admitted to our clinic between September 2008 and July 2009, with diabetic foot were included. All patients were evaluated according to age, gender, diabetes duration, 3-phase bone scintigraphy, Doppler ultrasound, amputation/reamputation levels, and hospitalization periods. Patients underwent 3-phase bone scintigraphy using technetium-99m methylene diphosphonate, and the most distal site of the region displaying perfusion during the perfusion and early blood flow phase was marked as the amputation level. Amputation level was determined by 3-phase bone scintigraphy, Doppler ultrasound, and inspection of the infection-free clear region during surgery.
Results
The amputation levels of the patients were as follows: finger in six (20%), ray amputation in five (16.6%), transmetatarsal in one (3.3%), Lisfranc in two (6.6%), Chopart in seven (23.3%), Syme in one (3.3%), below-the-knee in six (20%), above the knee in one (3.3%), knee disarticulation in one (3.3%), and two patients underwent amputation at other centers. After primary amputation, reamputation was performed on seven patients, and one patient was treated with debridement for wound site problems. No mortality was encountered during study.
Conclusions
We conclude that 3-phase bone scintigraphy prior to surgery could be a useful method to determine the amputation level in a diabetic foot. We conclude that further, comparative, more comprehensive, long-term, and controlled studies are required.
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