Endocrine Abstracts

Introduction: Diabetic foot osteomyelitis is a frequent complication of a preexisting infected foot wound. It is mostly the consequence of a soft tissue infection that spreads into the bone thus increasing the risk of amputation and the burden of foot care. The aim of this work is to describe the clinical and therapeutic aspect of diabetic foot osteomyelitis in our department.

Patients and Methods: It’s a retrospective and descriptive study conducted in our department, between January 2008 and January 2021, including all diabetic patients with foot osteomyelitis. Statistical analysis was performed using SPSS software.

Results: A total of 127 patients with a mean age of 57 years old were included. Male patients represented 61.3% of patients. Most of them were type 2 diabetics (84%) with a mean duration of 11.5 years and an average HbA1c of 11.3%. The diagnosis was essentially clinical, based on the chronic evolution of the ulcer, the presence of positive probe-to-bone test and the sausage-like toes. X-ray imaging often found erosion of cortical bone, osteolysis and in some cases bone sequestrations. Serum inflammatory markers as white blood cells (WBC), C-reactive protein and procalcitonin (PCT) were usually high when associated with soft-tissue or systemic infection. The treatment consisted of antibiotic therapy with an average duration of 9 weeks. Off-loading, perfect glycemic control and thromboembolic prevention were indicated in all patients. Among the cases, 9% were referred to surgical department for surgical management of necrosis and collections.

Conclusion: Osteiteomyelitis is an infection that can complicate diabetic foot ulcers. Early and optimal diagnosis and management limit the risk of unfavorable evolution, thus minimizing the risk of surgery and amputation.