‘Mind that diabetic foot’

THE concept of reconstructive and corrective surgery for the diabetic foot has evolved very recently, as a means to correct foot deformities.
This latest technique is presently being practiced in very few countries of the world. There are a few selected centres in the US, UK, Germany, Russia, Spain and Australia, with USA, which has seven podiatric schools performing such operations, topping the list.
In India, Amrita Institute of Medical Sciences, situated in Kochi, is the only institute doing this type of reconstructive surgery in high risk patients of totally deformed diabetic foot, thus obviating the traumatic need for amputations.
There is an entity called ‘Charcot’ in diabetic foot problems.
In prolonged diabetic foot problems there is an increased blood flow to the lower limbs, due to autonomic neuropathy, which causes demineralisation of the bones.
It is a tsunami like effect, just washing away the minerals of the bones.
Moreover, it stimulates certain cells which simply eat up the bones.
 All this weakens the bones, and makes them soft and pudgy.
This results in the collapse of the foot and ankle bones, making it impossible for the patient to walk.
Moreover, multiple increased pressure points are developed on the soles of the affected feet, where ulcers and calluses develop.
These act as portals for entry of bacteria.
As the cellular immunity of the patient is suppressed, even the slightest bacterial infection can cause a serious life-threatening problem, so much so that if the patient is not given proper treatment within 24 to 48 hours of the infection setting in, it may result in amputations or even death.
Worldwide, 50% of all leg amputations happen to people living with diabetes.
 In India, an estimated 50,000 amputations are carried out every year due to diabetes related foot problems.
By employing reconstructive and corrective surgical techniques, to correct the shape of the deformed feet and remove the high pressure points, a large number of such amputations can be prevented.
 Thus the patient can lead a near normal life, free from complications.