Diabetic foot reconstruction surgery

Diabetic foot reconstruction surgery

Diabetic foot reconstruction surgery corrects the damage to the foot and ankle caused by complications of diabetes. The high blood sugar levels of diabetes commonly cause nerve damage and poor circulation in the feet. These complications can result in deformity, lesions and other painful, debilitating foot problems:

  • Nerve damage can lead to the loss of sensation in your feet. Since you can't feel when something has injured or irritated your foot, a small blister can progress to a serious infection in a matter of days.
  • Poor circulation weakens and causes disintegration of the bones and joints in the foot and ankle. If you have diabetic foot, also known as Charcot foot, you're at higher risk for developing bone fractures. Due to numbness from nerve damage, you may not even realize that you have broken bones in your foot. If you continue to walk on your injured foot, you risk more serious damage such as chronic foot sores, joint dislocations and complete misalignment of the bones.

Surgery

If nonsurgical diabetic foot treatment, such as wearing a cast or special orthopaedic shoes, is not effective in preventing further deformity and joint destruction, your orthopaedist may recommend diabetic foot reconstruction surgery.

There are several forms of surgery that can repair a wide range of diabetic foot problems:

  • Mild deformity with tightness at the heel – In some cases there is only mild deformity and the patient experiences tightness in the heel. Ulcers also can cover the front of the foot due to changes in pressure. Achilles surgery can correct these problems by lengthening the Achilles tendon that runs down the back of the leg to the back of the foot. This surgical lengthening decreases pressure on the middle and back parts of the foot, allowing the foot to heal and reducing the chance of symptoms returning.
  • Bony prominence on the bottom of the foot – This type of surgery removes the large, bony bump that occurs on the bottom of the foot due to diabetic collapse.
  • Stable deformity – For this condition, the bony prominence is shaved away.
  • Unstable deformity – Simple removal of the bony prominence is not effective, because the bones surrounding it are too loose. These bones can easily move around and allow a new prominence to develop. Fusion and repositioning of the bones is needed to correct this side effect of diabetic collapse.
  • Fractures – When fractures occur in the softer bones of patients with diabetic foot, they are often more difficult to repair. Fusion will require more screws and plates for added stability and bone support.
  • Ankle deformity – Diabetic collapse of the ankle can lead to flatfoot. Surgical fusion surgery is usually needed on both the ankle and the joint below the ankle to hold the foot straight.

The multidisciplinary team of foot and ankle experts at Northwell Health Orthopaedic Institute performs diabetic foot reconstruction as well as a broad range of nonsurgical and surgical treatments for conditions that affect the foot and ankle.

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