To evaluate transmetatarsal amputation in diabetic foot through the Amit Jain’s system of practice – An experience from 2 different centre’s

Özet

The aim of this study was to evaluate trans metatarsal amputation (TMA) done in diabetic foot through Amit Jain’s universal classification and scoring system and assess major amputations done in them. We conducted a descriptive retrospective analysis from 2 center’s namely Amit Jain’s Institute of Diabetic Foot &Wound Care at Brindhavvan Areion Hospital and at Department of surgery, Raja Rajeswari medical college, Bengaluru, India. The study period was from January 2017 to June 2018. 15 patients were recruited in the study with 73.3% of them being males. Around 20 % of them were above 70 years of age. Majority of patients who underwent TMA had open stump and it had significant association with duration of diabetes. Specialist diabetic foot surgeon had significant propensity to close the stump after trans metatarsal amputation (P<0.001). Patients who ended up in major amputation after TMA had a significant Amit Jain’s surgical score of 16 and above (P-0.010). Type 1 diabetic foot complicationswere the most common cause for trans metatarsal amputation in diabetic foot with abscess being the commonest pathological lesion in this series. This study on trans metatarsal amputation in diabetic foot is uniquely done through Amit Jain’s system of practice for diabetic foot which utilizes a simple descriptive universal classification that categorizes variety of lesions in diabetic foot into 3 tier system and through Amit Jain’s scoring system that predicts major amputation in diabetic foot thereby abiding the law of classification that suggests utilizing combination of classifications for diabetic foot for a better analysis.