Hilberink, Yentl (2025) Gunstige Ulcusgenezing en Recidief Uitkomsten na Minimaal Invasieve Voorvoetreconstructies bij Diabetische Voetulcera in ZGT Almelo. thesis, Medicine.
Full text available on request.Abstract
Diabetic foot ulcers (DFU) represent severe complications of diabetes mellitus (DM), with a lifetime incidence of 34%. Risk factors such as diabetic neuropathy, peripheral arterial disease, and foot deformities contribute to the development and recurrence of DFU. DFU are associated with high morbidity with amputations occurring in 20% of DFU-patients and a 5-year mortality rate of 50-70% after amputations. Although conservative offloading achieves a ulcus healing rate of 90%, 65% of cases experience ulcer recurrence. Minimal invasive diabetic forefoot reconstructions (MIDF) for DFU are not routinely recommended in treatment according to Dutch guidelines, and there is a lack of studies reporting clinical outcomes for this approach. This study was a retrospective observational cohort study that investigated the outcomes of MIDF performed at Ziekenhuis Groep Twente (ZGT), including a flexor tenotomy (FT), percutaneous or open achilles tendon lengthening (ATL), floating metatarsal osteotomy (FMO), hallux foot reconstruction (HFR) or combinations of these procedures. Patient data must be available for at least two weeks postoperatively. In 31 patients with a total of 33 operated feet, the primary outcomes assessed were ulcer healing rates, ulcer healing time, and recurrence rates. Secondary outcomes included amputation rates and other postoperative complications. Of the 33 operated feet, 29 had an ulcer classified as Texas Classification 1 or higher, of which 93,1% achieved complete healing, with a median healing time of 46 days, and 25,9% experienced recurrence during a median follow-up period of 600 days. Additionally, 6,1% underwent secondary amputation, 30,3% developed infections, and 24,3% experienced transfer lesions. The results of MIDF at ZGT are encouraging. However, larger prospective multicenter studies with a more reliable follow-up are required to draw more precise conclusions and investigate the high incidence of transfer lesions.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Cate, Dhr. W.A. ten and Kappert, K. and Vermeer, M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 09 Mar 2026 15:05 |
| Last Modified: | 09 Mar 2026 15:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3903 |
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