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diabetic foot ulcer treatment in baltimore maryland

Achilles Lengthening for Diabetic Foot Ulcers

Baltimore Foot Doctor, Baltimore Podiatrist, Dr. Daniels Diabetic Foot Blog, Healthy Feet, We Treat Feet Staff , , , , , ,

Diabetic Foot Ulcer treatment at WeTreatFeet Podiatry, Foot and Ankle Care, Baltimore, Maryland.

Dr. Mikel Daniels

Dr. Mikel Daniels
President , Chief Medical Officer, and Managing Member at WeTreatFeet

 

Diabetic foot ulcers are a common complication of diabetes, affecting up to 25% of patients with diabetes during their lifetime. One of the main causes of diabetic foot ulcers is peripheral neuropathy, a condition that causes nerve damage, leading to loss of sensation in the feet. As a result, patients with diabetic foot ulcers are at an increased risk of developing serious infections and amputations.

Achilles tendon lengthening (ATL) is a surgical procedure that has been used to treat diabetic foot ulcers. The procedure involves lengthening the Achilles tendon to reduce pressure on the forefoot and increase the offloading of pressure areas. By reducing the pressure on the foot, ATL can promote healing of diabetic foot ulcers and prevent further complications.

Several studies have shown the effectiveness of ATL in treating diabetic foot ulcers. A randomized controlled trial published in the Journal of the American Podiatric Medical Association found that patients who underwent ATL had a significantly higher rate of complete ulcer healing compared to those who received standard care alone (71.4% vs. 20.0%). Another study published in the journal Diabetes Care found that ATL significantly reduced the risk of ulcer recurrence and amputation in patients with diabetic foot ulcers.

While ATL is generally considered a safe and effective treatment for diabetic foot ulcers, it is not without risks. Complications can include wound dehiscence, infection, and nerve damage. Patients considering ATL should discuss the risks and benefits with a WeTreatFeet Podiatrist

Multiple studies have shown, Achilles tendon lengthening is a successful treatment option for diabetic foot ulcers. It has been shown to promote healing and prevent complications in patients with peripheral neuropathy. However, patients should be aware of the potential risks and consult WeTreatFeet before undergoing the procedure.

#DiabeticFootUlcers #AchillesTendonLengthening #PeripheralNeuropathy #DiabetesCare #JAPMA #WeTreatFeet #Podiatry #Podiatrist #DFU #ulcer #amputation

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What is the diabetic foot?

Dr. Daniels Diabetic Foot Blog , , , ,

If you have diabetes, one of the most common issues and concerns is your foot.  Your foot is a complex structure consisting of 26 bones, 33 joints, and 120 muscles/ligaments/nerves[1].  Each structure has a unique purpose, and diabetes can causes alternation in function for any of them.

The most common problem we see in diabetics is diabetic peripheral neuropathy.  This is nerve damage that is a result of elevated glucose that is the root cause of all other diabetic foot problems.  With neuropathy, there are 3 main types; Sensory, Autonomic, and Motor.  While most people have an understanding of the loss of sensation associated with sensory neuropathy, the other two types can cause significant problems, and must be considered in any article about the diabetic foot.

Autonomic nervous system is part of your body responsible for involuntary action.  These are things like your heart beat, dilation and constrictions of the blood vessels, and secretion of natural skin oils, called sebum.  [2]  In the diabetic foot, these cause changes in the flow of blood to the foot, the amount of sweat your foot can produce, and how fast the blood flows.  These symptoms develop over years of disease progression, and the progression is enhanced under poorly controlled glucose levels.[3]

Motor neuropathy is a progressive loss of muscle tone and strength.  This results in weakness and muscle atrophy.  Most common in the upper and lower extremities, symptoms include cramping, twitching, and muscle wasting.  As in sensory and autonomic neuropathy, diabetes is a common cause, but other factors can contribute to each of these problems.  [4]  Motor neuropathy is the cause for problems associated with progressive hammertoe and bunion deformities.

When diabetes causes complications to your foot, it is related to each one of these types of neurologic conditions.  Sensory loss creates a situation where you can’t feel your foot.  Autonomic changes allow skin to become dry, atrophic, and easily damaged.  Motor neuropathy causes changes in the foot shape and mechanics, increasing pressure points, leading to the development of musculoskeletal imbalance.

I always tell my patients that when it comes to diabetes, if you live long enough, you are subject to all of these problems.  That being said, the better controlled your diabetes is, the longer and slower these symptoms progress, and the less likely to result in an infection, ulceration, or amputation.  Good quality foot care, proper shoes, glycemic control, and some education can go a long way in preventing loss of limb or life, a problem that occurs 73,000 times a year.[5]  This number is more than half of what it was 20 years ago due to proper education and better understanding of these problems.

 

[1] http://www.nytimes.com/health/guides/symptoms/foot-pain/print.html

[2] https://medlineplus.gov/autonomicnervoussystemdisorders.html

[3] https://medlineplus.gov/ency/article/000776.htm

[4] https://rarediseases.info.nih.gov/diseases/11011/multifocal-motor-neuropathy

[5] http://www.healthline.com/health/diabetes/diabetes-amputation#is-it-needed2