Date:31/05/2007 URL: http://www.thehindu.com/2007/05/31/stories/2007053111090200.htm

Karnataka - Bangalore

Diabetics, don't ignore that troublesome foot

Nagesh Prabhu

Damage to nerves and blood vessels of the legs are the main cause for amputation

ADVICE: Podiatric surgeon Robert Frykberg (left) with Director of the Jain Institute of Vascular Sciences K.R. Suresh. — Photo: V. Sreenivasa Murthy

BANGALORE: Diabetics, who often develop gangrene on their feet, which can lead to amputation, can prevent it by opting for a minor surgery for correction of foot deformities. The procedure is aimed at correcting a foot deformity by either loosening a tendon or tackling an infected bone in the foot and can help prevent future amputation, according to Robert Frykberg, a leading American podiatric surgeon.

Dr. Frykberg, who conducted a diabetic foot surgery workshop at Bhagwan Mahaveer Jain Hospital here recently, told The Hindu that damage to nerves and blood vessels of the legs were the main cause for amputation in diabetics. Fifty doctors from across the country attended the workshop. He spoke about the entire spectrum of preventive and therapeutic foot care.

"Neuropathy (nerve damage) is a more common cause of foot problems. This causes loss of sensation and disturbs the normal architecture and shape of the foot, hence exposing areas of the foot to high pressure during walking. This can cause ulcers, which could lead to amputation," Dr. Frykberg said.

According to K.R. Suresh, Director of the Jain Institute of Vascular Sciences, India has an estimated 44 million diabetics as against an estimated two million in the U.S. An estimated 20 million diabetics undergo amputation each year. "The figure, we feel, is grossly underestimated."

People with foot problems often go to the doctor too late, when the foot is ulcerated. "As these patients lose sensation in the foot, they often continue walking, leading to more damage. This leads to limbs getting deformed, adding pressure, leading to ulcers. But surgery can help correct the deformity and consequently the chances of developing an ulcer," he said.

While many foot problems respond to non-surgical treatment, some are best treated by podiatric surgery.

This is particularly effective for persistently painful conditions or where the foot is being affected by deformity.