TY - JOUR
T1 - The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study
AU - Hedegaard Andersen, Jonas
AU - Rasmussen, Anne
AU - Frimodt-Møller, Marie
AU - Rossing, Peter
AU - Kirketerp-Møller, Klaus
AU - Engberg, Susanne
PY - 2019/12
Y1 - 2019/12
N2 - Aim: The aim of this study was to evaluate outcomes of needle tenotomies as a treatment option for hammer, mallet and claw toes in patients with diabetes. Methods: This was a retrospective study where all patients receiving flexor tendon tenotomy by needle at our outpatient clinic were identified through the electronic patient record system. Results: A total of 81 patients that had 106 tenotomy procedures performed were identified. The 81 included (68% male) had an average age of 65.4 years, and 27 (33%) had Type 1 diabetes. Of the 106 procedures 36 were performed due to an ulcer on the feet. Of the 36 treated ulcers, 34 (94%) healed in an average time of 28 days. Tenotomies performed to prevent impending ulcers from progressing to active ulcers, were performed 84 times in total. Of the 84 procedures 6 patients progressed to an active ulcer. No serious complications i.e. infections or amputations in relation to the procedure were registered. Conclusion: Needle flexor tenotomies are a relatively safe and effective treatment compared to tenotomies done by scalpel, both as treatment for ulcers and to prevent formation of new ulcers associated with hammer, mallet and claw toe deformities. As a side note, transfer lesions are avoidable if all toes on one or both feet are tenotomized in one procedure.
AB - Aim: The aim of this study was to evaluate outcomes of needle tenotomies as a treatment option for hammer, mallet and claw toes in patients with diabetes. Methods: This was a retrospective study where all patients receiving flexor tendon tenotomy by needle at our outpatient clinic were identified through the electronic patient record system. Results: A total of 81 patients that had 106 tenotomy procedures performed were identified. The 81 included (68% male) had an average age of 65.4 years, and 27 (33%) had Type 1 diabetes. Of the 106 procedures 36 were performed due to an ulcer on the feet. Of the 36 treated ulcers, 34 (94%) healed in an average time of 28 days. Tenotomies performed to prevent impending ulcers from progressing to active ulcers, were performed 84 times in total. Of the 84 procedures 6 patients progressed to an active ulcer. No serious complications i.e. infections or amputations in relation to the procedure were registered. Conclusion: Needle flexor tenotomies are a relatively safe and effective treatment compared to tenotomies done by scalpel, both as treatment for ulcers and to prevent formation of new ulcers associated with hammer, mallet and claw toe deformities. As a side note, transfer lesions are avoidable if all toes on one or both feet are tenotomized in one procedure.
KW - Deformities
KW - Diabetic foot ulcer
KW - Needle
KW - Offloading
KW - Preventive surgery
KW - Tenotomy
U2 - 10.1016/j.jcte.2019.100208
DO - 10.1016/j.jcte.2019.100208
M3 - Journal article
C2 - 31844632
AN - SCOPUS:85074138428
SN - 2214-6237
JO - Journal of Clinical and Translational Endocrinology
JF - Journal of Clinical and Translational Endocrinology
M1 - 100208
ER -
