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Jose Luis Lazaromartinez - One of the best experts on this subject based on the ideXlab platform.
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Metatarsal Head resections in diabetic foot patients a systematic review
Journal of Clinical Medicine, 2020Co-Authors: Irene Sanzcorbala, Yolanda Garciaalvarez, Francisco Javie Alvaroafonso, Aroa Tardaguilagarcia, Josep M Garciaalamino, Jose Luis LazaromartinezAbstract:A systematic review and proportional meta-analysis were carried out to investigate the complications that occur after surgical Metatarsal Head resection in diabetic foot patients. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist recommendations were applied, and the selected studies were evaluated using a Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist. PubMed (Medline) and Embase (Elsevier) were searched in December 2019 to find clinical trials, cohort studies, or case series assessing the efficacy of the Metatarsal Head resection technique in diabetic foot patients. The systematic review covered 21 studies that satisfied the inclusion criteria and included 483 subjects. The outcomes evaluated were the time to heal, recurrence, reulceration, amputation, and other complications. The proportion of recurrence was 7.2% [confidence interval (CI) 4.0–10.4, p < 0.001], that of reulceration was 20.7% (CI 11.6–29.8, p < 0.001), and that of amputation was 7.6% (CI 3.4–11.8, p < 0.001). A heterogeneity test indicated I2 = 72.6% (p < 0.001) for recurrences, I2 = 94% (p < 0.001) for reulcerations, and I2 = 79% (p < 0.001) for amputations. We conclude that Metatarsal Head resections in diabetic foot patients are correlated with significant complications, especially reulceration.
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differences in the sub Metatarsal fat pad atrophy symptoms between patients with Metatarsal Head resection and those without Metatarsal Head resection a cross sectional study
Journal of Clinical Medicine, 2020Co-Authors: Raul Jua Molinesbarroso, Yolanda Garciaalvarez, Jose Luis Garciaklepzig, Esthe Garciamorales, Francisco Javie Alvaroafonso, Jose Luis LazaromartinezAbstract:We aimed to evaluate the differences in the sub-Metatarsal skin and fat pad atrophy between patients at a high risk of ulceration with and without previous Metatarsal Head resection. A cross-sectional study was performed in a diabetic foot unit involving 19 participants with a history of Metatarsal Head resection (experimental group) and 19 (control group) without a history of Metatarsal Head resection but with an ulcer in other locations in the Metatarsal Head. No participants had active ulcerations at study inclusion. Sub-Metatarsal skin thickness and fat pad thickness in the first and second Metatarsals were evaluated by an ultrasound transducer. The experimental group showed sub-Metatarsal fat pad atrophy (3.74 ± 1.18 mm and 2.52 ± 1.04 mm for first and second Metatarsal, respectively) compared with the control group (5.44 ± 1.12 mm and 4.73 ± 1.59 mm) (p < 0.001, confidence interval: (CI): 0.943–2.457 and p < 0.001, CI: 1.143–3.270 for first and second Metatarsal, respectively); however, sub-Metatarsal skin thickness was not different between groups (experimental 2.47 ± 0.47 mm vs. control 2.80 ± 0.58 mm (p = 0.063, CI: −0.019–0.672) and 2.24 ± 0.60 mm vs. 2.62 ± 0.50 mm (p = 0.066, CI: −0.027–0.786) for first and second Metatarsal, respectively). Patients with previous Metatarsal Head resection showed sub-Metatarsal fat pad atrophy, which could be associated with the risk of reulceration in the Metatarsal Head.
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complications associated with the approach to Metatarsal Head resection in diabetic foot osteomyelitis
International Wound Journal, 2019Co-Authors: Aroa Tardaguilagarcia, Raul Jua Molinesbarroso, Yolanda Garciaalvarez, Francisco Javie Alvaroafonso, Irene Sanzcorbala, Jose Luis LazaromartinezAbstract:The aim of this study was to evaluate the recovery time and the development of complications in the dorsal and plantar approach to Metatarsal Head resections (MHR) in patients with diabetic foot ulcers complicated by osteomyelitis. A retrospective study was carried out involving 108 patients who underwent MHRs for the treatment of diabetic foot osteomyelitis. Two cohorts were defined: dorsal approach with incision closed with sutures and plantar approach with ulcer healed using conservative treatment. The main outcomes were the weeks until healing and complications related to the approaches. Fifty-three patients (49.1%) underwent a plantar approach and 55 (50.9%) a dorsal approach. Both approaches rendered similar healing times. However, the patients undergoing a dorsal approach developed more post-surgical complications than patients treated through a plantar approach. The dorsal approach intervention was performed on smaller and shallower ulcers; however, more complications developed at follow up using this approach than through a plantar approach for MHR complicated with osteomyelitis.
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analysis of ulcer recurrences after Metatarsal Head resection in patients who underwent surgery to treat diabetic foot osteomyelitis
The International Journal of Lower Extremity Wounds, 2015Co-Authors: Irene Sanzcorbala, Raul Jua Molinesbarroso, Esthe Garciamorales, Jose Luis Lazaromartinez, Javie Aragonsanchez, Francisco Javie AlvaroafonsoAbstract:Metatarsal Head resection is a common and standardized treatment used as part of the surgical routine for Metatarsal Head osteomyelitis. The aim of this study was to define the influence of the amount of the Metatarsal resection on the development of reulceration or ulcer recurrence in patients who suffered from plantar foot ulcer and underwent Metatarsal surgery. We conducted a prospective study in 35 patients who underwent Metatarsal Head resection surgery to treat diabetic foot osteomyelitis with no prior history of foot surgeries, and these patients were included in a prospective follow-up over the course of at least 6 months in order to record reulceration or ulcer recurrences. Anteroposterior plain X-rays were taken before and after surgery. We also measured the portion of the Metatarsal Head that was removed and classified the patients according the resection rate of Metatarsal (RRM) in first and second quartiles. We found statistical differences between the median RRM in patients who had an ulcer recurrence and patients without recurrences (21.48 ± 3.10% vs 28.12 ± 10.8%; P = .016). Seventeen (56.7%) patients were classified in the first quartile of RRM, which had an association with ulcer recurrence (P = .032; odds ratio = 1.41; 95% confidence interval = 1.04-1.92). RRM of less than 25% is associated with the development of a recurrence after surgery in the midterm follow-up, and therefore, planning before surgery is undertaken should be considered to avoid postsurgical complications.
Musa Ugu Mermerkaya - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Metatarsal Head resurfacing hemiarthroplasty in the surgical treatment of hallux rigidus a retrospective study and mid to long term follow up
Foot and Ankle Specialist, 2018Co-Authors: Musa Ugu Mermerkaya, Erka Alka, Mehme AyvazAbstract:Background. The aim of this study was to evaluate the mid- to long-term outcomes of Metatarsal Head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first Metatarsal Head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final f...
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a comparison between Metatarsal Head resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty as surgical treatments for hallux rigidus a retrospective study with short to midterm follow up
Clinical Interventions in Aging, 2016Co-Authors: Musa Ugu Mermerkaya, Houma AdliAbstract:PURPOSE We evaluated the short- to midterm outcomes of Metatarsal Head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). PATIENTS AND METHODS From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2-3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent Metatarsal Head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II). All patients were clinically graded prior to surgery and at their final follow-up visits using the American Orthopedic Foot and Ankle Society's (AOFAS) hallux metatarsophalangeal-interphalangeal scale, a visual analog scale (VAS), and the "first metatarsophalangeal joint range of motion" (MTPJ ROM) score. RESULTS Metatarsal Head resurfacing was performed on 26 patients. Two patients underwent bilateral procedures, yielding a total of 28 cases in Group I. TJR was performed on 19 patients in Group II. Of the 26 Group I patients, 12 (46.2%) were male and 14 (53.8%) were female, with a mean age of 56.3±4.5 years (range: 47-63 years); the mean follow-up duration was 29.9±5.2 months. Of the 19 Group II patients, eight (42.1%) were male and eleven (57.9%) were female, with a mean age of 57.1±5.8 years (range: 45-66 years); the mean follow-up duration was 27.1±7.5 months. Significant improvements were evident in the AOFAS scores, and the VAS scores decreased, in both groups. No significant difference was evident between groups I and II. CONCLUSION After failure of conservative treatment in patients with moderate-to-severe HR, both MTPJ hemiarthroplasty and TJR were associated with effective recovery of toe function and MTPJ ROM, as well as good short- to midterm functional outcomes.
Mehme Ayvaz - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Metatarsal Head resurfacing hemiarthroplasty in the surgical treatment of hallux rigidus a retrospective study and mid to long term follow up
Foot and Ankle Specialist, 2018Co-Authors: Musa Ugu Mermerkaya, Erka Alka, Mehme AyvazAbstract:Background. The aim of this study was to evaluate the mid- to long-term outcomes of Metatarsal Head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first Metatarsal Head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final f...
Houma Adli - One of the best experts on this subject based on the ideXlab platform.
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a comparison between Metatarsal Head resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty as surgical treatments for hallux rigidus a retrospective study with short to midterm follow up
Clinical Interventions in Aging, 2016Co-Authors: Musa Ugu Mermerkaya, Houma AdliAbstract:PURPOSE We evaluated the short- to midterm outcomes of Metatarsal Head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). PATIENTS AND METHODS From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2-3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent Metatarsal Head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II). All patients were clinically graded prior to surgery and at their final follow-up visits using the American Orthopedic Foot and Ankle Society's (AOFAS) hallux metatarsophalangeal-interphalangeal scale, a visual analog scale (VAS), and the "first metatarsophalangeal joint range of motion" (MTPJ ROM) score. RESULTS Metatarsal Head resurfacing was performed on 26 patients. Two patients underwent bilateral procedures, yielding a total of 28 cases in Group I. TJR was performed on 19 patients in Group II. Of the 26 Group I patients, 12 (46.2%) were male and 14 (53.8%) were female, with a mean age of 56.3±4.5 years (range: 47-63 years); the mean follow-up duration was 29.9±5.2 months. Of the 19 Group II patients, eight (42.1%) were male and eleven (57.9%) were female, with a mean age of 57.1±5.8 years (range: 45-66 years); the mean follow-up duration was 27.1±7.5 months. Significant improvements were evident in the AOFAS scores, and the VAS scores decreased, in both groups. No significant difference was evident between groups I and II. CONCLUSION After failure of conservative treatment in patients with moderate-to-severe HR, both MTPJ hemiarthroplasty and TJR were associated with effective recovery of toe function and MTPJ ROM, as well as good short- to midterm functional outcomes.
Francisco Javie Alvaroafonso - One of the best experts on this subject based on the ideXlab platform.
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Metatarsal Head resections in diabetic foot patients a systematic review
Journal of Clinical Medicine, 2020Co-Authors: Irene Sanzcorbala, Yolanda Garciaalvarez, Francisco Javie Alvaroafonso, Aroa Tardaguilagarcia, Josep M Garciaalamino, Jose Luis LazaromartinezAbstract:A systematic review and proportional meta-analysis were carried out to investigate the complications that occur after surgical Metatarsal Head resection in diabetic foot patients. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist recommendations were applied, and the selected studies were evaluated using a Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist. PubMed (Medline) and Embase (Elsevier) were searched in December 2019 to find clinical trials, cohort studies, or case series assessing the efficacy of the Metatarsal Head resection technique in diabetic foot patients. The systematic review covered 21 studies that satisfied the inclusion criteria and included 483 subjects. The outcomes evaluated were the time to heal, recurrence, reulceration, amputation, and other complications. The proportion of recurrence was 7.2% [confidence interval (CI) 4.0–10.4, p < 0.001], that of reulceration was 20.7% (CI 11.6–29.8, p < 0.001), and that of amputation was 7.6% (CI 3.4–11.8, p < 0.001). A heterogeneity test indicated I2 = 72.6% (p < 0.001) for recurrences, I2 = 94% (p < 0.001) for reulcerations, and I2 = 79% (p < 0.001) for amputations. We conclude that Metatarsal Head resections in diabetic foot patients are correlated with significant complications, especially reulceration.
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differences in the sub Metatarsal fat pad atrophy symptoms between patients with Metatarsal Head resection and those without Metatarsal Head resection a cross sectional study
Journal of Clinical Medicine, 2020Co-Authors: Raul Jua Molinesbarroso, Yolanda Garciaalvarez, Jose Luis Garciaklepzig, Esthe Garciamorales, Francisco Javie Alvaroafonso, Jose Luis LazaromartinezAbstract:We aimed to evaluate the differences in the sub-Metatarsal skin and fat pad atrophy between patients at a high risk of ulceration with and without previous Metatarsal Head resection. A cross-sectional study was performed in a diabetic foot unit involving 19 participants with a history of Metatarsal Head resection (experimental group) and 19 (control group) without a history of Metatarsal Head resection but with an ulcer in other locations in the Metatarsal Head. No participants had active ulcerations at study inclusion. Sub-Metatarsal skin thickness and fat pad thickness in the first and second Metatarsals were evaluated by an ultrasound transducer. The experimental group showed sub-Metatarsal fat pad atrophy (3.74 ± 1.18 mm and 2.52 ± 1.04 mm for first and second Metatarsal, respectively) compared with the control group (5.44 ± 1.12 mm and 4.73 ± 1.59 mm) (p < 0.001, confidence interval: (CI): 0.943–2.457 and p < 0.001, CI: 1.143–3.270 for first and second Metatarsal, respectively); however, sub-Metatarsal skin thickness was not different between groups (experimental 2.47 ± 0.47 mm vs. control 2.80 ± 0.58 mm (p = 0.063, CI: −0.019–0.672) and 2.24 ± 0.60 mm vs. 2.62 ± 0.50 mm (p = 0.066, CI: −0.027–0.786) for first and second Metatarsal, respectively). Patients with previous Metatarsal Head resection showed sub-Metatarsal fat pad atrophy, which could be associated with the risk of reulceration in the Metatarsal Head.
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complications associated with the approach to Metatarsal Head resection in diabetic foot osteomyelitis
International Wound Journal, 2019Co-Authors: Aroa Tardaguilagarcia, Raul Jua Molinesbarroso, Yolanda Garciaalvarez, Francisco Javie Alvaroafonso, Irene Sanzcorbala, Jose Luis LazaromartinezAbstract:The aim of this study was to evaluate the recovery time and the development of complications in the dorsal and plantar approach to Metatarsal Head resections (MHR) in patients with diabetic foot ulcers complicated by osteomyelitis. A retrospective study was carried out involving 108 patients who underwent MHRs for the treatment of diabetic foot osteomyelitis. Two cohorts were defined: dorsal approach with incision closed with sutures and plantar approach with ulcer healed using conservative treatment. The main outcomes were the weeks until healing and complications related to the approaches. Fifty-three patients (49.1%) underwent a plantar approach and 55 (50.9%) a dorsal approach. Both approaches rendered similar healing times. However, the patients undergoing a dorsal approach developed more post-surgical complications than patients treated through a plantar approach. The dorsal approach intervention was performed on smaller and shallower ulcers; however, more complications developed at follow up using this approach than through a plantar approach for MHR complicated with osteomyelitis.
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analysis of ulcer recurrences after Metatarsal Head resection in patients who underwent surgery to treat diabetic foot osteomyelitis
The International Journal of Lower Extremity Wounds, 2015Co-Authors: Irene Sanzcorbala, Raul Jua Molinesbarroso, Esthe Garciamorales, Jose Luis Lazaromartinez, Javie Aragonsanchez, Francisco Javie AlvaroafonsoAbstract:Metatarsal Head resection is a common and standardized treatment used as part of the surgical routine for Metatarsal Head osteomyelitis. The aim of this study was to define the influence of the amount of the Metatarsal resection on the development of reulceration or ulcer recurrence in patients who suffered from plantar foot ulcer and underwent Metatarsal surgery. We conducted a prospective study in 35 patients who underwent Metatarsal Head resection surgery to treat diabetic foot osteomyelitis with no prior history of foot surgeries, and these patients were included in a prospective follow-up over the course of at least 6 months in order to record reulceration or ulcer recurrences. Anteroposterior plain X-rays were taken before and after surgery. We also measured the portion of the Metatarsal Head that was removed and classified the patients according the resection rate of Metatarsal (RRM) in first and second quartiles. We found statistical differences between the median RRM in patients who had an ulcer recurrence and patients without recurrences (21.48 ± 3.10% vs 28.12 ± 10.8%; P = .016). Seventeen (56.7%) patients were classified in the first quartile of RRM, which had an association with ulcer recurrence (P = .032; odds ratio = 1.41; 95% confidence interval = 1.04-1.92). RRM of less than 25% is associated with the development of a recurrence after surgery in the midterm follow-up, and therefore, planning before surgery is undertaken should be considered to avoid postsurgical complications.
