The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study

Jonas Hedegaard Andersen; Anne Rasmussen; Marie Frimodt-Møller; Peter Rossing; Klaus Kirketerp-Møller; Susanne Engberg

doi:10.1016/j.jcte.2019.100208

The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study

Jonas Hedegaard Andersen^*, Anne Rasmussen, Marie Frimodt-Møller, Peter Rossing, Klaus Kirketerp-Møller, Susanne Engberg

^*Corresponding author for this work

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

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.

Original language	English
Article number	100208
Journal	Journal of Clinical and Translational Endocrinology
ISSN	2214-6237
DOIs	https://doi.org/10.1016/j.jcte.2019.100208
Publication status	Accepted/In press - Dec 2019

Keywords

Deformities
Diabetic foot ulcer
Needle
Offloading
Preventive surgery
Tenotomy

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@article{496e4b25cd6f482cb5e3003ce6599b64,

title = "The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study",

abstract = "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.",

keywords = "Deformities, Diabetic foot ulcer, Needle, Offloading, Preventive surgery, Tenotomy",

author = "{Hedegaard Andersen}, Jonas and Anne Rasmussen and Marie Frimodt-M{\o}ller and Peter Rossing and Klaus Kirketerp-M{\o}ller and Susanne Engberg",

year = "2019",

month = dec,

doi = "10.1016/j.jcte.2019.100208",

language = "English",

journal = "Journal of Clinical and Translational Endocrinology",

issn = "2214-6237",

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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 -

The effect of needle tenotomy on hammer, mallet and claw toe deformities in patients with diabetes, a retrospective study

Abstract

Keywords

UN SDGs

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