Rescue from amputation

With an open wound on his foot, Peter S. to the doctor. The diagnosis: diabetic foot syndrome. The amputation threatens. A specialist team in the Helios clinical center Erfurt however can save the foot.

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Erfurt. It starts with an open, weeping spot on the right foot. Peter S. feels no pain, treats the wound with a sticking plaster. His heart is weak, so he has water retention in his foot more often.

But this time it is different. The swelling comes back. And it gets worse.

Peter S. has a so-called Charcot foot, a special form of diabetic foot syndrome. His foot skeleton has collapsed. The bones press against the skin. This leads to pressure damage and open wounds. Since the beginning of the year, the 64-year-old has been treated for diabetes mellitus. Too high blood sugar attacks blood vessels and nerve tracts in the long run. Diabetics have a reduced sensation of pain as a result, which is first noticeable in the feet. With fatal consequences: Every year in Germany, around 40.000 feet and toes amputated. Those affected usually notice too late that something is wrong.

Rescue from amputation

Peter S. threatens amputation. The Clinic for Trauma Surgery and Orthopedics at Helios Klinikum Erfurt decides against it: "We can save the foot," senior physician Andreas Grafenstein is certain. In collaboration with vascular surgeons, diabetologists, orthopedists and the in-house wound team, the surgeon develops the best possible treatment for Peter S. First, doctors treat the wound and prescribe antibiotic therapy. Three weeks later, Andreas Grafenstein rebuilds the skeleton of the foot in a four-hour operation. To do this, he removes a part from the inside of the foot so that it is now shorter than the other one. To ensure that the bones can heal in their new position, a ring fixator weighing an impressive two kilograms is mounted in the operating room.

"The nurses on the ward say they’ve never seen anything like it," says Peter S., when he is back on his feet after the operation. He says it’s unusual, but he doesn’t feel the construction is a foreign body. "It rather creates a sense of belonging," he says with a smile. The fixator now supports the stabilization of the foot for eight to twelve weeks. Painkillers needed Peter S. not. "I can sleep well under the circumstances. The lack of pain sensation, which promoted the foot syndrome, makes the treatment bearable," he explains.

At home, a nursing service will take care of cleaning and caring for the wound. Peter S. is looking forward to the day when he can go to the office again. "In the long run, it gets boring at home," he says. And the prospects are good: Depending on the course of healing, another stabilizing operation on the bones may follow. Then he can walk again without walking aids.

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