See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/342824944

Minimally Invasive Surgery: Osteotomies for Diabetic Foot Disease

Article  in  Foot and Ankle Clinics of North America · July 2020

DOI: 10.1016/j.fcl.2020.05.006

CITATIONS READS

10 307

2 authors:

Carlo Biz Pietro Ruggieri

University of Padova University of Padova
120 PUBLICATIONS   1,558 CITATIONS    519 PUBLICATIONS   14,310 CITATIONS   

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Trauma advances View project

Book title: Tumors of the Sacrum. Diagnosis and Treatment of Benign and Malignant Tumors View project

All content following this page was uploaded by Carlo Biz on 23 July 2020.

The user has requested enhancement of the downloaded file.

M inima lly I n vas i ve Surge ry :
Osteotomies for Diabetic
Foot Disease
a,b, a
Carlo Biz, MD *, Pietro Ruggieri, MD, PhD

KEYWORDS
 Minimally invasive surgery  Percutaneous surgery  Neuropathic ulcers
 Distal metatarsal osteotomies  Distal metatarsal diaphyseal osteotomies
 Metatarsalgia  Diabetic foot

KEY POINTS
 The treatment of diabetic foot ulcers is still challenging, but the application of minimally
invasive surgery now represents a strategic management of these lesions to achieve
health goals, highly uncertain until a few years ago.
 Minimally invasive distal metatarsal diaphyseal osteotomy (DMDO) is based on a distal os-
teotomy proximal to the metatarsal neck to reduce the pressure on the ulcer and favor its
healing.
 The DMDO technique enables the restoration of the original harmonic distal parabola of
the forefoot when possible, or the creation of a new balanced forefoot arch, promoting
the healing of chronic pressure ulcers.
 This technique, in association with percutaneous osteotomies and tenotomies of pha-
langes, protects diabetic patients with minimal tissue damage, immediate postoperative
weight bearing, and reduced risk of potential infections, because it does not require metal
fixation.
 In a recent preliminary prospective study, DMDO was proved to be a safe and effective
method for promoting the healing of chronic diabetic foot ulcers, regardless of their
severity.

Video content accompanies this article at http://www.foot.theclinics.com.

INTRODUCTION

The diabetic foot could seem hopeless because the prognosis of diabetic patients
over the years often becomes inexorably worse. It is known that more than half of

a
Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopedic and Trauma-
tologic Clinic, University of Padova, Via Giustiniani 2, Padova 35128, Italy; b GRECMIP-MIFAS
(Groupe de Recherche et d’Etude en Chirurgie Mini-Invasive du Pied-Minimally Invasive Foot
and Ankle Society), Merignac, France
* Corresponding author. Department of Surgery, Oncology and Gastroenterology DiSCOG, Or-
thopedic and Traumatologic Clinic, University of Padova, Via Giustiniani 2, Padova 35128, Italy.
E-mail address: carlo.biz@unipd.it

Foot Ankle Clin N Am - (2020) -–-

https://doi.org/10.1016/j.fcl.2020.05.006 foot.theclinics.com
1083-7515/20/ª 2020 Elsevier Inc. All rights reserved.

View publication stats