Treatment of Central Plantar Space Infection Following Diabetic Foot Infection of Central Toe Gangrene

Abstract

Infections of central plantar space affect the plantar vascular arch, leading to thrombosis of metatarsal arteries and to central toe necrosis. Such infections are critical and require proper drainage.
We carried out central toe amputation and resection of the metatarsal head and the metatarsophalangeal joint capsule simultaneously in order to drain central plantar space and to control infection following diabetic foot infection from central toe gangrene. The problematic dead space after metatarsal head resection was kept open for treatment in secondary healing.
Six patients underwent our procedure, and all wounds healed. No recurrences ensued and no additional amputations were needed. None of the patients demonstrated deformed plantar arches, and all were able to walk after wound healing by wearing an insole.
In conclusion, our procedure is effective in the treatment of infections of central plantar space following diabetic foot infection from central toe gangrene.