The Department of Endocrinology and Podiatric Surgery provides comprehensive care in all aspects of diabetic lower limb surgical problems. This integrated team approach, important in the proper management of the diabetic lower limb problems, is available in only a few centres worldwide. Our evaluation and management techniques are of world standards.
The concept of surgical correction for the diabetic foot and ankle deformity has recently evolved as a means to correct foot deformities secondary to long standing diabetes. This re-shaping of a deformed foot or toes by surgical correction is presently being done in a large way in a few countries only like in US, UK, Russia, Germany, Spain, and Australia. These surgeries help to prevent the formation of callus and ulcers of the foot and thus, these surgeries can prevent amputations in diabetics. We are the only major center in India where these reconstructive surgeries are being performed routinely in high-risk diabetic foot patients. By employing these novel surgical techniques a large number of amputations are being prevented. The cases we manage include large numbers of extensive lower-limb necrotizing fasciitis, various types of foot infections and Charcot’s cases some with marked destruction of the foot and ankle bones, and many others with grossly deformed toes and foot. We have a footwear factory, with trained staff, making diabetic footwear, providing high quality preventive, post–operative and rehabilitative footwear.
We are also conducting a post MS one year fellowship in podiatric surgery and a two-year podiatry assistant paramedical course. We are the only institute in Asia to conduct these two courses.
To avoid the serious complications of pin-tract infections, wire breakage and others associated with the application of external fixators in diabetic patients, we have devised an entirely new and novel technique of foot and ankle stabilization for the reconstruction of destroyed Charcot foot and ankle, called ‘The Amrita Sling Technique’. This has been published in ‘The Journal of Diabetic Foot Complications’, from the United States, in February 2009. In the past two years, we have successfully operated on over 20 cases of destroyed rare hind-foot Charcot cases, using this technique, with excellent results. We are also using polymethyl methacrylate as replacement prosthesis for unsalvagable Charcots foot bones. We have also synthesised a new polymer based footwear for diabetic patients.
By comprehensive management, we have been able to maintain a limb salvage rate of 91.5%, in diabetic foot and ankle diseases, comparable to the best centers in the world.
Our institute has been conducting the international “Amrita Diabetic Foot Conference' (A.D.F.C.) since 2009. The conference features talks and live surgical demonstrations by well known podiatric surgeons from the United States. We also invite endocrinologists from other countries who have special interest in the management of diabetic foot problems.