{"title":"糖尿病香肠趾:发病率、表现和结果。","authors":"Kaissar Yammine, Joseph Mouawad, Ghadi Abou Orm, Chahine Assi, Fady Hayek","doi":"10.1111/iwj.70002","DOIUrl":null,"url":null,"abstract":"<p>Osteomyelitis (OM) in diabetic foot infection could have many presentations such as an infected ulcer spreading to the bone or superimposed to Charcot neuroarthropathy. However, the sausage toe as a diabetic OM presentation was very rarely investigated; therefore, this study aims to assess the prevalence and signs of this presentation along with treatment modalities and outcomes. This is a retrospective series of patients presenting a sausage toe on admission. Several methods were conducted to diagnose OM, and three treatment modalities were applied. Two groups were compared: acute and chronic sausage toes. Outcomes were defined as sausage toe prevalence, ulcer location, OM prevalence, and comparative treatment results. Out of 82 diabetic toe infection cases, 24 (30%) presented as ‘sausage toe’. The side of the proximal interphalangeal joint of the lateral toes was the most frequent ulcer location (50%), mostly on the dorsal aspect followed by the side aspect. There were 15 (62.5%) acute cases and 9 (37.5%) chronic cases. MRI showed signs of OM in 21 (87.5%) cases and signs of septic arthritis in 3 (12.5%) cases. At the final follow-up, a successful treatment was recorded in five (20%) cases with antibiotics alone. Out of the 19 (42%) procedures, conservative surgery was performed successfully in 8 (58%) cases while amputation was needed in 11 (45.8%) cases. There was no significant difference in amputation frequency between acute and chronic groups. This is the first study documenting the sausage toe as a prevalent presentation of diabetic toe infection. The deformity is conclusive of deep infection with a very high osteomyelitis frequency. Surgery is often required for infection control and healing, mainly for chronic cases, and treatment outcomes did not differ between acute and chronic sausage toe groups. It could be beneficial to include this entity in the diabetic wound classification systems.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263806/pdf/","citationCount":"0","resultStr":"{\"title\":\"The diabetic sausage toe: Prevalence, presentation and outcomes\",\"authors\":\"Kaissar Yammine, Joseph Mouawad, Ghadi Abou Orm, Chahine Assi, Fady Hayek\",\"doi\":\"10.1111/iwj.70002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Osteomyelitis (OM) in diabetic foot infection could have many presentations such as an infected ulcer spreading to the bone or superimposed to Charcot neuroarthropathy. However, the sausage toe as a diabetic OM presentation was very rarely investigated; therefore, this study aims to assess the prevalence and signs of this presentation along with treatment modalities and outcomes. This is a retrospective series of patients presenting a sausage toe on admission. Several methods were conducted to diagnose OM, and three treatment modalities were applied. Two groups were compared: acute and chronic sausage toes. Outcomes were defined as sausage toe prevalence, ulcer location, OM prevalence, and comparative treatment results. Out of 82 diabetic toe infection cases, 24 (30%) presented as ‘sausage toe’. The side of the proximal interphalangeal joint of the lateral toes was the most frequent ulcer location (50%), mostly on the dorsal aspect followed by the side aspect. There were 15 (62.5%) acute cases and 9 (37.5%) chronic cases. MRI showed signs of OM in 21 (87.5%) cases and signs of septic arthritis in 3 (12.5%) cases. At the final follow-up, a successful treatment was recorded in five (20%) cases with antibiotics alone. Out of the 19 (42%) procedures, conservative surgery was performed successfully in 8 (58%) cases while amputation was needed in 11 (45.8%) cases. There was no significant difference in amputation frequency between acute and chronic groups. This is the first study documenting the sausage toe as a prevalent presentation of diabetic toe infection. The deformity is conclusive of deep infection with a very high osteomyelitis frequency. Surgery is often required for infection control and healing, mainly for chronic cases, and treatment outcomes did not differ between acute and chronic sausage toe groups. It could be beneficial to include this entity in the diabetic wound classification systems.</p>\",\"PeriodicalId\":14451,\"journal\":{\"name\":\"International Wound Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263806/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Wound Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/iwj.70002\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Wound Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/iwj.70002","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
糖尿病足感染中的骨髓炎(OM)有多种表现形式,如感染性溃疡向骨骼扩散或与夏科神经关节病相叠加。然而,香肠趾作为糖尿病 OM 的一种表现形式却很少被研究;因此,本研究旨在评估这种表现形式的发病率、体征以及治疗方法和效果。这是一项对入院时出现香肠趾患者的回顾性系列研究。研究采用了多种方法对 OM 进行诊断,并采用了三种治疗方法。两组患者进行了比较:急性和慢性香肠趾。结果定义为香肠趾发病率、溃疡位置、OM发病率和治疗效果比较。在 82 例糖尿病足趾感染病例中,有 24 例(30%)表现为 "香肠趾"。外侧脚趾近端指间关节的一侧是最常见的溃疡位置(50%),主要在背侧,其次是侧方。急性病例有 15 例(62.5%),慢性病例有 9 例(37.5%)。磁共振成像显示,21 例(87.5%)患者有 OM 征象,3 例(12.5%)患者有化脓性关节炎征象。在最后的随访中,有 5 例(20%)病例仅使用抗生素就获得了成功治疗。在 19 例(42%)手术中,8 例(58%)成功实施了保守手术,11 例(45.8%)需要截肢。急性组和慢性组的截肢频率没有明显差异。这是第一项将 "香肠趾 "作为糖尿病趾感染常见表现形式的研究。这种畸形是深部感染的确凿证据,骨髓炎的发生率非常高。感染控制和愈合通常需要手术,主要针对慢性病例,急性和慢性香肠趾组的治疗效果并无差异。将这种情况纳入糖尿病伤口分类系统可能会有所帮助。
The diabetic sausage toe: Prevalence, presentation and outcomes
Osteomyelitis (OM) in diabetic foot infection could have many presentations such as an infected ulcer spreading to the bone or superimposed to Charcot neuroarthropathy. However, the sausage toe as a diabetic OM presentation was very rarely investigated; therefore, this study aims to assess the prevalence and signs of this presentation along with treatment modalities and outcomes. This is a retrospective series of patients presenting a sausage toe on admission. Several methods were conducted to diagnose OM, and three treatment modalities were applied. Two groups were compared: acute and chronic sausage toes. Outcomes were defined as sausage toe prevalence, ulcer location, OM prevalence, and comparative treatment results. Out of 82 diabetic toe infection cases, 24 (30%) presented as ‘sausage toe’. The side of the proximal interphalangeal joint of the lateral toes was the most frequent ulcer location (50%), mostly on the dorsal aspect followed by the side aspect. There were 15 (62.5%) acute cases and 9 (37.5%) chronic cases. MRI showed signs of OM in 21 (87.5%) cases and signs of septic arthritis in 3 (12.5%) cases. At the final follow-up, a successful treatment was recorded in five (20%) cases with antibiotics alone. Out of the 19 (42%) procedures, conservative surgery was performed successfully in 8 (58%) cases while amputation was needed in 11 (45.8%) cases. There was no significant difference in amputation frequency between acute and chronic groups. This is the first study documenting the sausage toe as a prevalent presentation of diabetic toe infection. The deformity is conclusive of deep infection with a very high osteomyelitis frequency. Surgery is often required for infection control and healing, mainly for chronic cases, and treatment outcomes did not differ between acute and chronic sausage toe groups. It could be beneficial to include this entity in the diabetic wound classification systems.
期刊介绍:
The Editors welcome papers on all aspects of prevention and treatment of wounds and associated conditions in the fields of surgery, dermatology, oncology, nursing, radiotherapy, physical therapy, occupational therapy and podiatry. The Journal accepts papers in the following categories:
- Research papers
- Review articles
- Clinical studies
- Letters
- News and Views: international perspectives, education initiatives, guidelines and different activities of groups and societies.
Calendar of events
The Editors are supported by a board of international experts and a panel of reviewers across a range of disciplines and specialties which ensures only the most current and relevant research is published.