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Risk of necrosis in the adjacent toe after one-toe fillet flap in diabetic foot: Retrospective study of 107 cases over 5 years

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Author(s)
Junhyung KimKyubeom KimJaehoon ChoiWoonhyeok JeongTaehee JoSangho Oh
Keimyung Author(s)
Kim, Jun HyungChoi, Jae HoonJeong, Woon HyeokJo, Tae HeeOh, Sang Ho
Department
Dept. of Plastic Surgery (성형외과학)
Journal Title
Journal of Orthopaedic Surgery (Hong Kong)
Issued Date
2020
Volume
28
Issue
3
Keyword
amputationdiabetic footfillet flapnecrosistoes
Abstract
Purpose:
Fillet flap is a "spare part" concept. This technique allows the defect to be covered without donor site morbidity. Over the past 5 years, there were 107 diabetic foot cases of one-toe fillet flap in our hospital. After the operation, in some patients, there was necrosis of the adjacent toe that required additional amputation. The aim of our study was to determine the cause of necrosis of the adjacent toe after fillet flap.

Methods:
The patients were divided into two groups. One group had no necrosis of the adjacent toe (group A) after the operation, and the other group had necrosis of the adjacent toe that required additional amputation after the operation (group B). Then, to confirm the cause of the additional necrosis of the adjacent toe, χ 2 tests, Fisher's tests, and logistic regression tests were performed.

Results:
A total of 107 patients were included, and 48 patients needed additional amputation. The logistic regression test revealed that a fillet flap at the metatarsophalangeal joint (MTPJ), horizontal sutures, and a fillet flap at the second toe were significant risk factors for developing necrosis.

Conclusions:
If a fillet flap with a second toe, fillet flap on MTPJ level and horizontal closure after fillet flap is needed, the chance of developing necrosis of the adjacent toe and additional revisional surgery must be communicated preoperatively.
Keimyung Author(s)(Kor)
김준형
최재훈
정운혁
조태희
오상호
Publisher
School of Medicine (의과대학)
Citation
Junhyung Kim et al. (2020). Risk of necrosis in the adjacent toe after one-toe fillet flap in diabetic foot: Retrospective study of 107 cases over 5 years. Journal of Orthopaedic Surgery (Hong Kong), 28(3), 1–7. doi: 10.1177/2309499020951944
Type
Article
ISSN
2309-4990
Source
https://journals.sagepub.com/doi/10.1177/2309499020951944
DOI
10.1177/2309499020951944
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43190
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Plastic Surgery (성형외과학)
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