{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:32:29Z","timestamp":1777613549251,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aims of this prospective study were first to evaluate the safety and effectiveness of minimally invasive distal metatarsal diaphyseal osteotomies (DMDOs) for treating a consecutive series of diabetic patients with chronic plantar diabetic foot ulcers (CPDFUs) and second to assess their clinical-functional and radiographic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A consecutive series of patients affected by diabetes mellitus with CPDFUs, not responsive to previous nonoperative management, underwent DMDO. The CPDFUs were evaluated using the University of Texas Diabetic Wound Classification System (UTDWC). Demographic parameters, Foot &amp; Ankle Society (AOFAS) scores, visual analog scale (VAS) scores, healing times, and complications were recorded. Maestro et al criteria and bone callus formation were analyzed radiologically. Statistical analysis was carried out ( P &lt; .05). Thirty consecutive enrolled patients with a mean age of 66.7 (range, 53-75) years presented 35 CPDFUs with a mean diameter of 16.3 mm and a mean duration of 10.3 months. The most frequent grade of the UTDWC was IIIB (42.9%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All ulcers recovered with a mean healing time of 7.9 \u00b1 4.0 (range, 4-17) weeks. AOFAS scores improved significantly from 55.3 to 81.4 points ( P &lt; .001). At a mean follow-up of 25.3 months (range, 18-71), no cases of ulcer recurrence were recorded, while a major complication or a wound infection required longer healing time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Minimally invasive DMDO was a safe and effective method in promoting CPDFU healing, regardless of the grade of severity, by the reduction of the high plantar pressure under the metatarsal heads. This technique improved functional and radiographic outcomes with few complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100717735640","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T07:43:13Z","timestamp":1510040593000},"page":"83-92","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":50,"title":["Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (DMDO) for Chronic Plantar Diabetic Foot Ulcers"],"prefix":"10.1177","volume":"39","author":[{"given":"Carlo","family":"Biz","sequence":"first","affiliation":[{"name":"Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Gastaldo","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miki","family":"Dalmau-Pastor","sequence":"additional","affiliation":[{"name":"Human Anatomy and Embryology Unit, Experimental Pathology and Therapeutics Department, University of Barcelona, Barcelona, Spain"},{"name":"Faculty of Health Sciences at Manresa, University of Vic Central, University of Catalonia, Manresa, Spain"},{"name":"Groupe de Recherche et d\u2019Etude en Chirurgie Mini-Invasive du Pied, Merignac, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Corradin","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Volpin","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy"},{"name":"Department of Trauma and Orthopaedics, University College London Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,11,7]]},"reference":[{"key":"bibr1-1071100717735640","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"bibr2-1071100717735640","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.5.855"},{"key":"bibr3-1071100717735640","doi-asserted-by":"publisher","DOI":"10.3402\/dfa.v2i0.10358"},{"key":"bibr4-1071100717735640","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-016-0491-x"},{"key":"bibr5-1071100717735640","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2016.06.002"},{"key":"bibr6-1071100717735640","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2702"},{"key":"bibr7-1071100717735640","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713515447"},{"key":"bibr8-1071100717735640","unstructured":"Centers for Disease Control and Prevention: National diabetes fact sheet: general information and national estimates on diabetes in the United 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