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Lower Extremity Amputations Fall in Medicare Patients
Drastic amputations at proximal levels drop, while orthopedic treatments for diabetic foot ulcer rise

FRIDAY, July 12 (HealthDay News) -- During the past decade, the use of lower extremity amputations (LEAs), particularly proximal amputations, in Medicare patients has declined markedly, and the use of orthopedic treatments for diabetic foot ulcer (DFU) has increased sharply, according to research published in the July issue of Foot & Ankle International.

Daniel A. Belatti and Phinit Phisitkul, M.D., of the University of Iowa in Iowa City, analyzed Medicare Part B claims data for 2000 to 2010 to examine patterns of LEAs and orthopedic treatments for DFU.

The researchers found that rates of LEAs decreased by 28.8 percent, from 282.5 to 201.0 per 100,000 Medicare enrollees, during the 10-year period. The largest decline occurred in amputations for the most proximal levels, and the smallest decline was for the most distal locations. Use of orthopedic treatments for DFU, such as Achilles tendon release and total contact casting, increased by 143.3 percent, from 26.0 to 63.3 per 100,000 enrollees, during the same period.

"Clearly, continued success in preventing lower limb amputations, and limiting those that do occur to more distal levels, will be an uphill battle," the authors write. "Future work is needed to rigorously demonstrate best practices in preventing LEA and to identify definitively the causes behind recent declines."

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