Treatment of Diabetic Bunionette Deformity with Ulcer Using S.E.R.I.(simple, effective, rapid, and inexpensive) Operation
10.14193/jkfas.2024.28.4.146
- Author:
Jaeyoung LEE
1
;
Jin-Wha CHUNG
Author Information
1. Department of Orthopedic Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
- Publication Type:Original Article
- From:Journal of Korean Foot and Ankle Society
2024;28(4):146-151
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Forefoot ulcers have been implicated as a causative factor in diabetic foot amputation. The treatment of a bunionette deformity with an ulcer is not well established. This study examined the outcomes of a S.E.R.I. (simple, effective, rapid, and inexpensive) operation for bunionette deformity with ulcers in diabetic neuropathy.
Materials and Methods:Between January 2014 and June 2022, 20 patients (20 feet) treated for the bunionette deformity with a S.E.R.I.operation were reviewed retrospectively. All patients had diabetic neuropathy. Eleven patients were female, and the mean age at the time of surgery was 62 years. The mean follow-up time was 16 months. Radiologically, the 4th, 5th intermetatarsal angle (4, 5 IMA), lateral deviation angle (LDA), and the length of the 5th metatarsal bone were analyzed preoperatively and after a 1-year follow-up, and the clinical healing time of the ulcer was also reviewed.
Results:The 4, 5 IMA and LDA were reduced from the mean preoperative values of 11.4° and 7.9° to 4.8° and 3.8°, respectively (p<0.05).The mean 5th metatarsal length was reduced from 64.3 mm to 61.2 mm (p<0.05). All ulcers were healed at 3 months with no recurrence at the final follow-up. Four patients showed delayed union, and nine patients had developed hard corn around the previous lesion.
Conclusion:The S.E.R.I. operation can be an acceptable treatment modality for bunionette deformity with an ulcer who has diabetic neuropathy by offloading the bunionette so that ulcer healing can occur.
