Plantar Fat Grafting and Tendon Balancing for the Diabetic Foot Ulcer in Remission
AuthorLuu, Cynthia A.
Rankin, Timothy M.
Pappalardo, Jennifer L.
Slepian, Marvin J.
Armstrong, David G.
AffiliationUniv Arizona, Coll Med, Dept Surg, SALSA
Univ Arizona, Dept Med
Univ Arizona, Dept Biomed Engn
MetadataShow full item record
PublisherLIPPINCOTT WILLIAMS & WILKINS
CitationPlantar Fat Grafting and Tendon Balancing for the Diabetic Foot Ulcer in Remission 2016, 4 (7):e810 Plastic and Reconstructive Surgery - Global Open
RightsCopyright © 2016 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractWe report on the use of free fat grafting as a means of redistributing normal and shear stress after healing of plantar diabetic foot wounds. Although fat augmentation (lipofilling) has been described previously as an approach to supplement defects and prevent atrophy, including use as an adjunct to wound healing and to mitigate pain in the foot, we are unaware of any reports in the medical literature that have described its use in the high-risk diabetic foot in remission. An active 37-year-old man with type 2 diabetes and neuropathy presented with gangrene of his fifth ray, which was amputated. He subsequently developed a chronic styloid process ulceration that progressed despite treatment. We performed a tibialis anterior tendon transfer and total contact casting. He went on to heal but with residual fat pad atrophy and recalcitrant preulcerative lesions. We then used autologous fat grafting for the plantar atrophy. The patient was able to successfully transition to normal shoe gear after 4 weeks with successful engraftment without complication or recurrence of the wound at 6 weeks. This therapy may provide a promising adjunct to increase ulcer-free days to the patient in diabetic foot remission.
NoteOpen access journal
VersionFinal published version
- Tissue Augmentation with Allograft Adipose Matrix For the Diabetic Foot in Remission.
- Authors: Shahin TB, Vaishnav KV, Watchman M, Subbian V, Larson E, Chnari E, Armstrong DG
- Issue date: 2017 Oct
- Promoting primary healing after ray amputations in the diabetic foot: the plantar dermo-fat pad flap.
- Authors: Altindas M, Cinar C
- Issue date: 2005 Sep 15
- The plantar fat pad and the diabetic foot--a review.
- Authors: Dalal S, Widgerow AD, Evans GR
- Issue date: 2015 Dec
- Hyperbaric oxygen therapy for non-healing ulcers in diabetes mellitus: an evidence-based analysis.
- Authors: Health Quality Ontario.
- Issue date: 2005
- Effect of Achilles tendon lengthening on neuropathic plantar ulcers. A randomized clinical trial.
- Authors: Mueller MJ, Sinacore DR, Hastings MK, Strube MJ, Johnson JE
- Issue date: 2003 Aug