Local signs and symptoms in relation to final amputation level in diabetic patients. A prospective study of 187 patients with foot ulcers

Jan Larsson, Carl-David Agardh, Jan Apelqvist, Anders Stenström

Research output: Contribution to journalArticlepeer-review

Abstract

Local signs and symptoms were evaluated in 187 consecutively presenting diabetic patients undergoing amputation for foot ulcers. From admission until final outcome the patients were treated by the same multidisciplinary team both as in- and out-patients. At the time of amputation, the types of lesions were superficial/deep ulcer (n 17), ulcer with deep infection, but without gangrene (n 40), and gangrene with or without infection (n 130). Healing after a minor amputation (below the ankle) occurred in 74 patients, while 88 patients healed after a major amputation (above the ankle), and 25 patients died before healing had occurred. Deep infection and presence of popliteal or pedal pulses were associated with healing after minor amputation and so were ulcers on the small toes, metatarsal head area and midfoot. Pain, progressive gangrene, intermittent claudication, and decubital and multiple ulcers were related to healing after major amputation. In a logistic regression analysis, pain, progressive gangrene and intermittent claudication remained. However, none of these factors excluded healing of a minor amputation and thus selection of amputation level in diabetic patients with foot ulcers cannot be based upon these factors exclusively.
Original languageEnglish
Pages (from-to)387-393
JournalActa Orthopaedica Scandinavica
Volume65
Issue number4
DOIs
Publication statusPublished - 1994

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Department of Orthopaedics (Lund) (013028000), Unit on Vascular Diabetic Complications (013241510), Diabetes and Endocrinology (013241530)

Subject classification (UKÄ)

  • Endocrinology and Diabetes

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