Sarcouncil Journal of Medicine and Surgery

Abstract: The study was done to determine the histopathological results of proximal bone samples of DFIs during minor amputations and to determine the relationship of the results with postoperative treatment outcomes. A retrospective, single-center study was carried out on 113 patients who underwent minor amputation (toe, ray, or transmetatarsal) of moderate-to-severe DFIs and proved to have osteomyelitis. Histopathological assessment of the proximity bone margins was done to determine osteomyelitis, inflammatory infiltrates, bone necrosis, and viability. A proper comparison of outcomes was made between patients who had a positive (n=38) and negative histopathology at the resection margin through the relevant statistical tests. Osteomyelitis of the proximal bone margin was detected in 33.6% (38/113) of the patients by histopathological examination. Positive-margins patients had a much poorer prognosis than negative-margins with lower treatment success rates (50.0 vs. 82.7), higher levels of complete wound healing (55.3 vs. 77.3), treatment time (14.8 vs. 8.6 weeks), and unplanned reoperation (36.8 vs. 14.7), proximal re-amputated (28.9 vs. 10.7), and infection recurrence (31.6 vs. 12 Histopathologic signs of osteomyelitis at the apical bone margin in minor amputation in DFIs is a powerful, independent risk factor, such as the failure of treatment, retarded bone healing, and re-amputation.