Controversies regarding radiological changes and variables predicting amputation in a surgical series of diabetic foot osteomyelitis

Abstract Background To investigate if radiological changes have any influence on the outcomes of surgical treatment of diabetic foot osteomyelitis. Methods Data of patients included in a prospective cohort who underwent surgical treatment for definitive osteomyelitis were analyzed. Cases were classi...

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Bibliographic Details
Published in:Foot and ankle surgery 2012-12, Vol.18 (4), p.233-236
Main Authors: Aragón-Sánchez, Javier, MD, PhD, Lázaro-Martínez, Jose L., DPM, PhD, Campillo-Vilorio, Nalini, MD, Quintana-Marrero, Yurena, RN, Hernández-Herrero, Maria J., MD
Format: Article
Language:English
Subjects:
Aged
Amputation
Bone infection
Diabetic foot
Diabetic Foot - complications
Diabetic Foot - diagnostic imaging
Diabetic Foot - surgery
Diabetic foot infections
Diabetic foot osteomyelitis
Foot ulcer
Humans
Orthopedics
Osteomyelitis - complications
Osteomyelitis - diagnostic imaging
Osteomyelitis - surgery
Predictive Value of Tests
Prospective Studies
Radiography
Radiology
Treatment Outcome
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Summary:Abstract Background To investigate if radiological changes have any influence on the outcomes of surgical treatment of diabetic foot osteomyelitis. Methods Data of patients included in a prospective cohort who underwent surgical treatment for definitive osteomyelitis were analyzed. Cases were classified according to radiological changes as “early osteomyelitis” when no radiological changes were found or in cases showing periosteal elevation and/or subcortical demineralization and/or cortical disruption. Cases showing sequestra and/or gross bone destruction were classified as “advanced osteomyelitis”. Results Early osteomyelitis was defined according to radiological findings in 37 cases (45.7%) and advanced in 44 (54.3%). Advanced osteomyelitis was not associated with the risk of undergoing amputation. Conclusions The bone changes seen in simple X-rays in cases of osteomyelitis do not have any prognostic value when surgical treatment is undertaken. The outcomes are more related to soft tissue involvement than bone destruction seen in simple X-rays.
ISSN:1268-7731
1460-9584
DOI:10.1016/j.fas.2012.01.005