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Pedal Amputations in Diabetes

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International Advances in Foot and Ankle Surgery

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Abstract

Diabetes is the leading cause of amputation worldwide. It has been said that “every 30 seconds a limb is lost as a consequence of diabetes.”1 In the United States, the annual incidence of lower extremity amputation in those with diabetes is 5–8 per 1,000.2,3 The causes of amputation are well understood. Foot ulcer precedes amputations in 84% of the cases.4 Up to 25% of those with diabetes will develop a foot ulcer over their lifetime.5 More than half of those ulcers will become infected, and 1 in 5 will necessitate an amputation.6 Approximately 60% of the limbs that are amputated are complicated by infection.7 This prompted our group to conceptualize the “steps to an amputation” shown in Fig. 31.1. There are opportunities for intervention at each of these steps, which might prevent the progression of the patient toward the final step – amputation.

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Author information

Authors and Affiliations

  1. Foot and Ankle Surgery, North Jersey Orthopaedic Specialists, Teaneck, NJ, 07666, USA

    Nicholas J. Bevilacqua D.P.M. (Associate)

  2. Amputation Prevention Center, Valley Presbyterian Hospital, Van Nuys, CA, USA

    Lee C. Rogers D.P.M.

  3. Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, University of Arizona, Tucson, AZ, USA

    David G. Armstrong D.P.M., M.D., Ph.D.

Authors
  1. Nicholas J. Bevilacqua D.P.M.
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  2. Lee C. Rogers D.P.M.
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  3. David G. Armstrong D.P.M., M.D., Ph.D.
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Corresponding author

Correspondence to Nicholas J. Bevilacqua D.P.M. .

Editor information

Editors and Affiliations

  1. Department of Sports Medicine, PAFMG-Palo Alto Division, Clark Bldg., 3rd Flr 795 El Camino Real, Palo Alto, CA, 94301, USA

    Amol Saxena

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Bevilacqua, N.J., Rogers, L.C., Armstrong, D.G. (2012). Pedal Amputations in Diabetes. In: Saxena, A. (eds) International Advances in Foot and Ankle Surgery. Springer, London. https://doi.org/10.1007/978-0-85729-609-2_31

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  • DOI: https://doi.org/10.1007/978-0-85729-609-2_31

  • Publisher Name: Springer, London

  • Print ISBN: 978-0-85729-608-5

  • Online ISBN: 978-0-85729-609-2

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