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John D. Martin, MD, Leigh Delbridge, MD. , Thomas S. Reeve, MD. , G

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Presentation on theme: "John D. Martin, MD, Leigh Delbridge, MD. , Thomas S. Reeve, MD. , G"— Presentation transcript:

1 Radical treatment of mal perforans in diabetic patients with arterial insufficiency 
John D. Martin, MD, Leigh Delbridge, MD *, Thomas S. Reeve, MD *, G.Patrick Clagett, MD  Journal of Vascular Surgery  Volume 12, Issue 3, Pages (September 1990) DOI: / (90) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 The location and distribution of ulcers involving a single metatarsal head. Seven additional patients had ulcers involving multiple metatarsal heads. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Illustration of operative technique. A, Dorsal skin incision and exposure of the metatarsal head. B, Transection of the metatarsal at the origin of the interosseus muscle and resection. C, Elliptical plantar ulcer excision. D, Primary closure of the plantar incision with interrupted nylon sutures. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 The intrinsic muscle palsy centers the vertical loading forces over the metatarsal head causing ulcer formation. Journal of Vascular Surgery  , DOI: ( / (90) ) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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