Lipsky BA, Senneville É, Abbas ZG, et al: Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev 36(suppl): e3280, 2020.
International Diabetes Federation. IDF Diabetes Atlas: eighth edition 2017. Available at: https://diabetesatlas.org/upload/resources/previous/files/8/IDF_DA_8e-EN-final.pdf. Accessed December 20, 2019.
Ndosi M, Wright-Hughes A, Brown S, et al: Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study. Diabet Med 35: 78, 2018.
Lázaro-Martínez JL, García-Madrid M, García-Álvarez Y, et al: Conservative surgery for chronic diabetic foot osteomyelitis: procedures and recommendations. J Clin Orthop Trauma 16: 86, 2020.
Seçkin MF, Özcan Ç, Çamur S, et al: Predictive factors and amputation level for reamputation in patients with diabetic foot: a retrospective case-control study. J Foot Ankle Surg 61: 43, 2022.
Hoffler HL, Honeycutt BJ, Brackney CK, et al: Reulceration and reoperation incidence after isolated partial fifth ray amputations: a multicenter study. J Foot Ankle Surg 61: 298, 2022.
Izumi Y, Satterfield K, Lee S, et al: Risk of reamputation in diabetic patients stratified by limb and level of amputation: a 10-year observation. Diabetes Care 29: 566, 2006.
Bus SA, van Netten JJ, Lavery LA, et al: IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev 32(suppl): 16, 2016.
Belatti DA, Phisitkul P: Declines in lower extremity amputation in the US Medicare population, 2000-2010. Foot Ankle Int 34: 923, 2013.
Wukich DK, Raspovic KM, Suder NC: Patients with diabetic foot disease fear major lower-extremity amputation more than death. Foot Ankle Spec 11: 17, 2018.
Krueger CA, Rivera JC, Tennent DJ, et al: Late amputation may not reduce complications or improve mental health in combat-related, lower extremity limb salvage patients. Injury 46: 1527, 2015.
Polikandrioti M, Vasilopoulos G, Koutelekos I, et al: Depression in diabetic foot ulcer: associated factors and the impact of perceived social support and anxiety on depression. Int Wound J 17: 900, 2020.
Polikandrioti M, Vasilopoulos G, Koutelekos I, et al: Quality of life in diabetic foot ulcer: associated factors and the impact of anxiety/depression and adherence to self-care. Int J Low Extrem Wounds 19: 165, 2020.
Background: Foot wounds are a serious medical condition that can progress rapidly. For patients who have failed conservative treatment, surgery to remove infected bone or surgically offload the wound may be necessary.
Methods: In our study, we looked at all patients at a single institution over a 7.5-year time period who underwent isolated sesamoidectomy for osteomyelitis or recurrent wounds. A total of 21 patients with 22 operative extremities and an average 430-day follow-up (21–1,346 days) were included in the study.
Results: We found a 36.3% reoperation rate due to persistent wound resistant to conservative treatment or infection, with the most common procedure being a partial first-ray amputation (27.3% of patients). We found that the average time to reoperation after the initial surgery was 152.9 days.
Conclusions: To our knowledge, this is the first study to look at reoperation rates after sesamoidectomy surgery for wounds. We conclude that isolated sesamoidectomy is an appropriate procedure for isolated osteomyelitis to the sesamoids or resistant wounds that have failed conservative treatment, with overall low reoperation rates compared with distal foot amputations.