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Credit: AOFAS
Rosemont, IL (July 8, 2013) –There have been dramatic decreases in the number and severity of lower limb amputations over the past decade, according to a new study published in the July 2013 issue of Foot & Ankle International. At the same time, orthopaedic advances in treating diabetic foot ulcers have become more commonplace, hopefully decreasing the need for amputation.
The statistics on diabetes prevalence and impact are sobering. Nearly 26 million U.S. children and adults, or 8 percent of the population, have diabetes, says the American Diabetes Association. The number of people living with diabetes is expected to reach 44 million individuals by 2034. The economic cost of diagnosed diabetes in the United States is $245 billion per year. Finally,diabetes is responsible for more than 60 percent of lower limb amputations from non-trauma causes.
Researchers at the University of Iowa Department of Orthopaedics and Rehabilitation studied lower extremity amputation rates and diabetic foot ulcer treatments under Medicare claims over a 10-year period from 2000-2010. The rate of lower extremity amputations declined 28.8 percent over the decade, but the number of claims for orthopaedic treatments for diabetic foot ulcers rose 143.3 percent during the same time period. Phinit Phisitkul, MD, is senior author of the study "Declines in Lower Extremmity Amputation in the US Medicare Population, 2000-2010" published in the July 2013 issue of Foot & Ankle International, the journal of the American Orthopaedic Foot & Ankle Society.
"The shift in amputation level observed in the Medicare population is also quite striking," said Dr. Phisitkul. "Amputations at the upper and lower leg level are down 47 percent, while amputations at the partial toe level increased by 24 percent. What this means for patients is increased mobility, independence and survival rates."
At the same time that amputations were becoming less frequent, the frequency of orthopaedic treatmentsfor diabetic foot ulcers rose significantly. The advances in orthopedic surgery include total contact casting, Achilles tendon release and calf muscle lengthening. These treatments help diabetic foot ulcers heal and help prevent their recurrence by relieving pressure where the ulcers tend to form.
"Further studies are required to determine the causes of the decrease in lower extremity amputation, which could be a combination of better preventive care, insulin control and the orthopaedic treatments. More work is also required to determine the best practices in preventing lower limb amputation," added Phisitkul.
For further information on how to take care of diabetic feet, or to find a local orthopaedic foot and ankle surgeon, visit the American Orthopaedic Foot & Ankle Society patient website at http://www.footcaremd.org.Foot & Ankle International is published by SAGE.
"Declines in Lower Extremity Amputation in the US Medicare Population, 2000-2010" by Daniel A. Belatti, BS and Phinit Phisitkul, MD published July 2013 in Foot & Ankle International. To read the full text of the article, free for a limited time, click here http://fai.sagepub.com/content/34/7/923.full.
About the AOFAS
The AOFAS promotes quality, ethical and cost-effective patient care through education, research and training of orthopaedic surgeons and other health care providers. It creates public awareness for the prevention and treatment of foot and ankle disorders, provides leadership, and serves as a resource for government, industry and the national and international health care community.
About Orthopaedic Foot and Ankle Surgeons
Orthopaedic foot and ankle surgeons are medical doctors (MD and DO) who specialize in the diagnosis, care, and treatment of patients with disorders of the musculoskeletal system of the foot and ankle. This includes the bones, joints, ligaments, muscles, tendons, nerves and skin. Orthopaedic foot and ankle surgeons use medical, physical, and rehabilitative methods as well as surgery to treat patients of all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle. Orthopaedic foot and ankle surgeons work with physicians of many other specialties, including internal medicine, pediatrics, vascular surgery, endocrinology, radiology, anesthesiology, and others. Medical school curriculum and post-graduate training proves the solid clinical background necessary to recognize medical problems, admit patients to a hospital when necessary, and contribute significantly to the coordination of care appropriate to each patient.
SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology, and medicine. An independent company, SAGE has principal offices in Los Angeles, London, New Delhi, Singapore and Washington DC. http://www.sagepublications.com.
Journal
Foot & Ankle International