Background and objective

. The term diabetic hand describes serious hand infections resulting from trauma, human or dog bite and drug abuse, in patients suffering from diabetes mellitus. The most frequent clinical manifestations are cellulitis, paronychia, tenosynovitis, deep abscess, septic arthritis and osteomyelitis.

We present our experience in the care of patients with diabetic hand, as the delay of diagnosis makes the treatment difficult and predisposes to greater complications.

Methods

A retrospective study was conducted on cases of diabetic hand in Plastic and Reconstructive Surgery Department at Hospital General "Dr. Eduardo Liceaga" in Mexico City (Mexico) from March 2013 to March 2018.

Results

The age range of the patients was from 19 to 87 years, having a total number of 42 patients, 23 female (55%) and 19 male (45%). Twenty-five patients (60%) did not report a history of surgery, meanwhile 17 (40%) had a surgical history: supracondylar amputation was found in 4 patients (10%) and infracondylar amputation in 1 patient (2%); remodelation of the finger was equivalent to 7%. The most frequent diagnosis was infectious tenosynovitis of 3rdfinger. The pathogen most frequently found was Enterobacter cloacae(14%). When analyzing the types of surgical treatment used, specifically amputation, there were outstanding differences when contrasting by gender and the presence of obesity in the patients: 52% of the female gender were amputated against 21% of the male group (p = .029 through Pearson’s X2); 43% of patients with obesity were amputed compared to 36% who did not have it (p = .061 through Pearson’s X2).

Conclusions

This pathology has a high incidence, however there is not enough literature to determine timely diagnosis and effective treatment, as there is yet no algorithm or some classification that helps the control and monitoring of patients.

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