• diabetic patients underwent 34 metatarsal head resections for chronic neuropathic ulceration. All ulcers were located on the plantar surface beneath the metatarsophalangeal joints. The ulcers had been present for a mean of 9.0 ± 7.8 months before operation, yet they healed in a mean of 2.4 1.6 months postoperatively. None recurred during the mean follow-up time of 13.8 ± 11.0 months. Moderate peripheral vascular disease, impaired renal function, and retinopathy did not affect the time required for ulcer healing. There were two complications: one wound infection and one hematoma. No extremities were lost, and none of the patients suffered any long-term sequelae. We recommend metatarsal head resection to achieve the healing of chronic diabetic foot ulcers under the metatarsophalangeal joints.
(Arch Surg. 1990;125:832-835)