Reoperation and Reamputation Rates After Isolated Sesamoidectomy for Foot Ulcers.

BACKGROUND

Foot wounds are a serious medical condition that can progress rapidly. For patients who have failed conservative treatment, surgery to remove infected bone or surgically offload the wound may be necessary.

METHODS

In our study, we looked at all patients at a single institution over a 7.5-year time period who underwent isolated sesamoidectomy for osteomyelitis or recurrent wounds. A total of 21 patients with 22 operative extremities and an average 430-day follow-up (21-1,346 days) were included in the study.

RESULTS

We found a 36.3% reoperation rate due to persistent wound resistant to conservative treatment or infection, with the most common procedure being a partial first-ray amputation (27.3% of patients). We found that the average time to reoperation after the initial surgery was 152.9 days.

CONCLUSIONS

To our knowledge, this is the first study to look at reoperation rates after sesamoidectomy surgery for wounds. We conclude that isolated sesamoidectomy is an appropriate procedure for isolated osteomyelitis to the sesamoids or resistant wounds that have failed conservative treatment, with overall low reoperation rates compared with distal foot amputations.