Current concepts in curative surgery for diabetic forefoot ulcers

Forefoot ulcerations in patients with diabetes are quite common. Underlying mechanical deformities of the foot in combination with neuropathy are the most important risk factors for ulcer development and adequate offloading is the mainstay of management. Most ulcers heal with local wound care, adequate blood supply, and pressure relief. If a foot deformity cannot be accommodated, ulcers will not heal or may recur. In this case, surgical correction of deformity is necessary. This paper reviews the most common procedures supported by medical evidence to heal neuropathic forefoot ulcers.