Tehran University Medical Journal

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Background: Diabetes mellitus is a common endocrine disorder with increasing prevalence. Diabetic foot is a costly and serious chronic complication of diabetes mellitus that if it does not controlled will cause severe morbidities in patients with diabetes mellitus. Based on the study of center of management and prevention of diseases about 230 milliard Rials were expended for direct costs of diabetes annually and instruction of patients about protection of foots in some countries, decrease rate of amputation between 44 to 85% and infact instruction of diabetic patients is the base of treatment and prevention of complications of diabetes mellitus.
Methods: In a cross sectional study with attention to one of important causes of refer of diabetic patients to hospitals diabetic ulcers of foots, we discuss about risk factors and ways of treatment and prevention of them. The study done on patients admitted in endocrinology unit of Imam Khomeini hospital. For analysis we used SPSS 11.5 program. Although the costs for patients are calculated.
Results: In this study from 245 patients that admitted because of diabetic foot (63.26% male and 36.73% female), 74 patients have done amputation. From these 74 patients (30.2%), 65.67% were male and 24.32% were female. Age average was 58.24+12.29 years And the mean duration of DM was 10.56+8.32 years and the past history of diabetic foot was present in 45.95% of them. Past history of smoking was present in 66.21% of patients.
Conclusion: From 245 patients from 1996 to 2001 that admitted because of diabetic foot, 155 patients (63.26%) were male and 90 patients (36.73%) were female. From this numbers the most of them were in 60-70 years old and the least were 20-30 years old. Gender of most of them was male. For treatment of this complication a lot of costs were necessary and instruction of patients decrease this complications.

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Background: Even though replantation surgery has now become a routine procedure, it remains delicate and demanding surgery, requiring adequate training and expertise in microsurgical techniques. Functional outcomes following replantation vary with the level of injury. Replants of the fingers distal to the flexor superficial are insertion, the hand at the wrist, and the upper extremity at the distal forearm can achieve good function. With the advent of refined microscopes, sutures, and needles, along with specialized surgical training, replantation has become a routine part of hand-surgery practice in centers all over the world. Clearly, survival does not equate with function. Amputations constitute multisystem injury, with disruption of skeletal support (bone), motor function (muscle), sensibility (nerve), circulation (blood vessel), and soft-tissue coverage (skin). A lot of News work-related accidents published daily. Complete amputation of the palm with sharp objects electric disrupts quality of life and irreversible effects on their life. Replantation or repair the damaged organ can improve their quality of life, functional body.

Case presentation: The case is a man with complete amputation of the palm while working with an electrical machine, at the same time as damage and severe crush was also the distal phalanx of the first finger of the right hand. Patient was admitted to the emergency unit at Fatemi Hospital of Ardabil city in January 2014, Iran, and underwent to surgery for replantation.

Conclusion: Complete amputation of palm and its successful replantation are among rarely occurred and reportable cases. Complete amputation of palm and successful replantation and the 10-month follow-up indicated that the patient had a successful operation. No abnormalities were found in the blood circulation, and finger grasping was acceptable. Nerve development was acceptable.

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