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Salvage of the First Ray With External Fixation in the High-Risk Patient

Limb Preservation Service, Vascular/Endovascular Surgery Service, Department of Surgery (MHS/TSR), Tacoma, Washington

Thomas S. Roukis, DPM, FACFAS

Limb Preservation Service, Vascular/Endovascular Surgery Service, Department of Surgery (MHS/TSR), Tacoma, Washington, thomas.s.roukis{at}us.army.mil

In diabetic patients, hallux and first-ray amputations significantly increase the risk of recurrent ulceration and more proximal amputation over time. This small, retrospective study demonstrates that salvage of the first ray can be reliably accomplished, even in high-risk patients, when basic principles of infection management are followed in conjunction with the appropriate use of external fixation. These techniques may help to improve the quality of life and reduce the overall medical resources required for the treatment of recurrent ulceration and amputation in this patient population.

Key Words: diabetic foot ulceration • external fixation • first-ray salvage • osteomyelitis

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