Mumbai- In India there are nearly 101 million Diabetic patients. Out of these patients 20% used to develop foot ulcers in their lifetime. According to WHO, diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputations. Foot ulcer is the pivotal event which leads to major amputations in Diabetic patients. So, the prevention of ulcer and if ulcer is there then healing of ulcer and prevention of recurrence is the most important strategy to prevent these amputations in Diabetic patients. Commenting on this Dr. Shrikant Bhoyar, Diabetic Foot Surgeon from Apex Superspeciality Hospital, Borivali says, “About 85% of ulcers are because of Neuropathy. Neuropathy makes the foot insensate and small injuries go unnoticed which later becomes the cause of major amputations. 45-year-old diabetic patient from Mira Road admitted in Apex Superspeciality Hospital, Borivali for foot ulcer treatment, as many doctors suggested amputation surgery. We decided to conduct Keller’s arthroplasty procedure which is a procedure to remove bone from the spot where your big toe joint meets the metatarsal bone and replace it with soft tissue. In this case Keller's arthroplasty 6 mm to proximal 1/3 of proximal phalanx bone is cut releasing all the adhesions and insertion of tendon on the base of proximal phalanx saving the blood supply and flexor and extensor tendons inserting at the base of distal phalanx. The patient is discharged after 48 hours of surgery and advised not to put pressure or weight on the operated foot for at least 10 days. This procedure is often done when your toe joint is affected by ulcer or wound. A Keller’s gap arthroplasty can help to heal this Inter phalangeal ulcer almost permanently and help you use your foot more freely.”
Dr. Shrikant Bhoyar further added that we have operated on about 38 cases of IP joint ulcers. The 1 st case was operated 6 years back and not a single patient has come back with recurrence. So, I can say that and supported by the data world over the treatment of this simple looking ulcer is Kellers’s gap arthroplasty to get almost permanent relief from this ulcer and prevent further complications. Neuropathy also makes the joints stiff and alters the biomechanics of the foot leading to focal points of increased pressure which again becomes the cause of ulceration. The Great Toe ulcers form 33% of all the ulcers in Diabetic patients. If not treated early the ulcers can become the cause of infection and amputation of the Great toe and of the leg. The main causative factors of ulceration are Neuropathy , vasculopathy and limited joint mobility. Prolonged hyperglycemia contributes to all these factors. In India Neuropathy plays an important part in causation of foot ulcers, so heal the ulcers and prevent amputation whenever possible. There are many preventive surgeries in diabetic patients with ulcers which most of the patients were not aware of which need to be addressed immediately in the Indian healthcare industry.
Apex Group of Hospitals is a chain of Hospitals managed and run by expert Medical Professionals with experience of 25 years. Currently Apex group of Hospit
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