Regional Variation in the Incidence of Diabetes-Related Lower Limb Amputations and Its Relationship with the Regional Factors / 대한족부족관절학회지

PURPOSE: To investigate the spatial distribution of diabetes-related lower limb amputations and analyze the relationship between the spatial distribution of diabetes-related lower limb amputations and regional factors. MATERIALS AND METHODS: This study was performed based on the data from the Korean Health Insurance Review and Assessment Service, in 2016. The unit of analysis was the administrative districts of city·gun·gu. The dependent variable was the age- and sex-adjusted incidence of diabetes-related lower limb amputations and the regional variables were selected to represent two aspects: socioeconomic factors, and health and medical factors. Along with traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for spatial analysis. RESULTS: The age- and sex-adjusted incidence of diabetes-related lower limb amputation varied according to region. OLS regression showed that the incidence of diabetes-related lower limb amputation had significant relationships with the health and medical factors (number of healthcare institution and doctors per 100,000 population). In GWR, the effects of regional factors were not consistent. CONCLUSION: The spatial distribution of the incidence of diabetes-related lower limb amputations and the effects of regional factors varied according to the regions. The regional characteristics should be considered when establishing health policy related to diabetic foot care.

The Fate of Fracture Fragment in Diabetic Calcaneal Insufficiency Avulsion Fracture / 체질인류학회지

Diabetic calcaneal insufficiency avulsion (CIA) fracture are unusual injury. The treatment may be challenging due to the low healing potential from diabetes or Charcot neuroarthropathy, so far. The poor surgical outcomes and surgical failures from treatment of the traumatic calcaneal avulsion fractures were associated with poor bone stock, lack of proper fixation, and the wound problem. Thus, the proper treatment for diabetic CIA fracture was still controversy. This report described two cases of diabetic CIA fracture treated with fixation of fracture fragment and calcaneal tenodesis. In both cases, fracture fragments were re-avulsed despite of fixation. Through investigation for the fate of fracture fragment from these cases, we discussed the proper treatment strategy in diabetic CIA fracture.