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Hi, I am a Consultant Orthopaedic Surgeon with special interest in Paediatric Orthopaedics, Complex Foot & Ankle surgery and Diabetic Foot reconstruction.

Non-healing diabetic foot ulcer, a common presentation to foot clinics. This is due to chronic pressure of bone on the skin resulting in skin breakdown, deep bony infection and if untreated, result in foot amputation.

Common causes of pressure on the skin is due to untreated bony deformities, which could be due to extra growth from the bone, or commonly, untreated defomrities from tighness of muscles around the ankle.

Surgical treatment involve, correction of defomrity with Tibialis posterior release, tendo-Achillis lengthening and corrective bony osteotomies.

Tightness of Tibialis anterior result in Midfoot adduction and supination. In Diabetic neuropathic foot, this result in non-healing ulcer on lateral proximal foot. #diabetic #foot #ulcer

Tendo-Achillis tightness is the major deforming force in the progression of midfoot Charot deformity. Early lengthening of tendon prevent further progression of the deformity. The tendon can be lengthened using Hoke technique in out-patient clinic setting. Pre and post procedure

Neuropathy (loss of sensation) is one of the complications of diabetes. Foot ulcers are due to either abnormal pressure from ill-fitting shoes or more commonly from underlying bony pressure. Successful treatment of ulcer should involve correction of underlying bony deformity.

#diabetes

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