en Orthopedic Surgery Orthopedic Surgery Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Diabetic ulceration leads to amputation in up to 85% of cases. Managing a diabetic ulcer requires an expert team to prevent wound progression and apply proper supportive procedures, decreasing the risk of amputation. This study aimed to compare the clinical efficacy of toe-sparing surgery and toe amputation in patients with diabetic foot ulcers.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods: </b>This cohort evaluated 54 consecutive patients with Diabetes Mellitus and chronic ulcers in the lower extremities. The patients were treated by bone resection with preserving toe and soft tissue or complete toe amputation. They were followed up for one year. We evaluated the relative risk for re-ulceration of the same toe, ulcers in other parts, increased levels of hemoglobin A1c (HbA1c), and infection between the two groups.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> The re-ulceration rate at the same toe was 12.9% in the toe amputation and 39.1% in the toe-sparing group (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.001). The prevalence of other amputations in the toe amputation and toe-sparing surgery groups was 29.0% and 17.4%, respectively (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.001). However, the infection rate was lower in the toe-sparing group (</span></span><span style="font-size:9.0pt">P </span><span style="font-size:9.0pt"><span style="font-style:normal">< 0.001).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> The re-ulceration rate was lower after toe amputation, and the infection rate was higher in the toe amputation group.</span></span></span></span></span></span></span></span><br> &nbsp; Amputation, Diabetic foot, Toes, Foot ulcer, Limb salvage, Toe-sparing surgery 248 251 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7510-1&slc_lang=en&sid=1 Ali Yeganeh yeganeh.a@iums.ac.ir 200319475328460093252 200319475328460093252 No Department of Orthopedic Surgery, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Alireza Kalantar Motamed kalmotam@yahoo.com 200319475328460093253 200319475328460093253 Yes Department of General Surgery, Rasoul-e-Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Salar Baghbani salar.baghbani1992@gmail.com 200319475328460093254 200319475328460093254 No Orthopedic Surgery Ward, Besat Hospital, Trauma and Surgery Research Center, Aja University of Medical Sciences, Tehran, Iran Sahand Cheraghiloohesara sahand.cheraghi@gmail.com 200319475328460093255 200319475328460093255 No Trauma and Injury Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Milad Gorgani drmiladgorgani@gmail.com 200319475328460093256 200319475328460093256 No Trauma and Injury Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mohammad Soleimani mohammad.soleimani.md@gmail.com 200319475328460093257 200319475328460093257 No Trauma and Injury Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran