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Friday, March 17, 2000

AOFAS educates people on importance of foot care

The American Orthopaedic Foot and Ankle Society (AOFAS) is joining with the American Academy of Orthopaedic Surgeons (AAOS) to educate people with diabetes about the vital importance of good foot care.

According to Ronald W. Smith, MD, an associate clinical professor in the division of orthopaedic surgery at the University of California at Los Angeles and past president of the AOFAS, some 50 percent of diabetics develop some sort of in-fection on their foot that could lead to amputation. About 60,000 below the knee amputations are done on diabetics every year.

And many of them could be prevented.

"We can reduce the number of amputations that are done every year," Dr. Smith said. "Through education, research and simply wearing appropriate footwear, we can prevent a good portion of the amputations that are done every year."

Smith is spearheading the AOFAS Year of the Diabetic Foot campaign along with his colleagues Robert B. Anderson, MD, chief of foot and ankle service, department of orthopaedic surgery at Carolinas Medical Center; Stephen Conti, MD, assistant professor in the department of orthopaedic surgery, the University of Pittsburgh; and Michael Pinzur, MD, a professor in the department of orthopaedic surgery, Loyola University in Maywood, Ill.

"We're not so much saving lives as we are saving legs," he said of the education and research campaign, which began last year, and could, Dr. Conti said, last indefinitely.

Many doctors do not regularly check the feet of diabetics and they should, Dr. Conti added. Too often, diabetic patients develop neuropathy, a gradual loss of nerve function, especially in the foot. With such a condition, they may develop foot ulcers and not even know it. Such ulcers, left untreated, could lead to amputation.

Doctors or patients can test for neuropathy by running a monofilament along the bottom of the foot. If the patient doesn't feel the line touching his foot, he has neuropathy and is at great risk of developing ulcers that will not be treated.

Many people are reluctant to have the ulcers treated even if they are aware of them because treatment costs average about $36,000. A below the knee amputation, however, can cost upwards of $60,000.

As part of the educational effort, the doctors said people should know that insurance covers such treatments and, in many cases, will cover preventative measures including inserts for shoes.

"The most important thing to remember is that prevention is the best way to avoid problems with the diabetic foot," Dr. Anderson said. "It's all common sense, but common sense is not all that common."

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Last modified 17/March/2000 by IS