Introduction
Percutaneous forefoot surgery is a minimally invasive surgical technique with the advantages of lower morbidity and earlier recovery by allowing immediate weight bearing. These benefits represent an ideal indication for older patients with high comorbidity. This study presents the functional outcomes of this surgical technique in a series of patients with these characteristics at a tertiary-level university hospital.
Methodology
A retrospective observational study of a case series of patients who underwent this minimally invasive technique between 2022 and 2023. Epidemiological variables were collected, and the outcomes were analysed based on three parameters: resolution of ulcers, disappearance of keratoses, and the ability to wear shoes. The complete resolution of all three parameters evaluated was considered satisfactory, two resolved was acceptable, and the persistence of two or more was unsatisfactory. Given the characteristics of the series collected, only clinical follow-up was performed, with no radiological follow-up in any case.
Results
The first 30 cases operated on were collected. They had a mean age of 82.8 years and an average follow-up of 6.57 months, sufficient to evaluate medium-term postoperative results. The results were satisfactory in 83 % of cases. Half of the patients had two or more comorbidities—type 2 diabetes mellitus being the most prevalent—and the higher the number of comorbidities, the greater the risk of an unsatisfactory outcome. Surgical complications were few and mostly mild, affecting only 33 % of patients (10 cases). Those with ulcers before surgery presented the worst outcomes.
Conclusions
Percutaneous forefoot surgery for severe digital deformities in older patients with high comorbidity is an ideal minimally invasive technique with good functional outcomes and an acceptable percentage of complications.
Level of evidence
IV. Type of study: Case series.
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