A novel approach to the management of the diabetic foot: metatarsal excision in the treatment of osteomyelitis.

OBJECTIVE: To describe the procedure and outcomes of metatarsal excision in seven patients treated for osteomyelitis in the diabetic foot. RESULTS: Average age was 60.6 (48-83) years. The mean length of hospital stay was 33.5 (3-50) days (excluding one patient who died from hospital acquired pneumonia). All remaining patients had negative wound cultures after a mean 7.4 (0-20) days of antibiotic treatment after procedure and were discharged from hospital 16.9 (2-48) days after surgery. Two patients developed wound infections after discharge. Pre-operative levels of mobility were achieved within a mean of 12.6 days (range 2-40). CONCLUSIONS: In diabetic patients, metatarsal excision may be better than transmetatarsal amputation.