Saving the Foot: Simple Orthopaedic Intervention to Adjust the Mechanics of the Ulcerated Neuropathic Foot Improves Outcomes by Reducing Sepsis, Amputation & Mortality

Description

In this presentation, orthopedic registrar Jessica Blong discusses collaborative research conducted at Salford Royal Hospital, focusing on the surgical intervention for patients with neuropathic foot ulcers resulting from diabetes. The study, entitled "Saving the foot," outlines how simple orthopedic adjustments can significantly improve outcomes by reducing the rates of amputation, sepsis, and mortality associated with diabetic foot ulcers. With projections indicating that over 5 million people in the UK will have diabetes by 2025, and a substantial percentage developing foot ulcers, the implications of this research are critical.



Blong highlights the severity and costs of complications arising from diabetic foot ulcers, estimated at over £800 million annually in the UK. Unlike traditional approaches where orthopedic surgeons only intervene in emergencies, this study advocates for earlier surgical interventions to alleviate mechanical pressure on ulcerated areas, which has shown promise in expediting healing and improving resolution rates. The presentation reports on different interventions, including Achilles tendon lengthening and tendon tenotomy, detailing surgical procedures, costs, and patient recovery processes.



Results from the data collected between April 2019 and October 2021 reveal a stark contrast in ulcer healing outcomes compared to conservatively managed patients, with the surgical groups achieving nearly 100% resolution rates and significantly fewer complications. The average cost of the surgical intervention was found to be £1,211 per patient, in contrast to nearly £10,000 for those managed conservatively. Ultimately, the study demonstrates an average saving of £8,691 per patient and outlines plans for future randomized controlled trials and training additional staff to expand the reach of these effective interventions.

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