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Diabetes · Limb salvage
Diabetic foot — limb saved
Often referred in late, often told amputation is the only route. Joint orthoplastic reconstruction with Mr Pafitanis frequently isn’t.
Often referred in late, often told amputation is the only route. Joint orthoplastic reconstruction with Mr Pafitanis frequently isn’t.
Most patients here arrive having been told the foot cannot be saved. Sometimes that is right. Often it is not. The job is an honest assessment of what is salvageable, what is realistic, and what the orthoplastic team can do together that neither discipline can do alone.
A combined assessment with our orthoplastic colleague (Mr Pafitanis) where appropriate — bone, soft tissue and vascular status looked at together. Imaging is targeted: weight-bearing CT for Charcot, MRI for osteomyelitis, vascular review where flow is the concern.
Three options, written down: continue current pathway, targeted reconstruction (often single-stage debridement + bony correction + flap cover), or amputation. The honest probability of healing, time off feet, and risk of recurrence is given for each.
Reconstruction is sequenced with the orthoplastic team, the diabetes physicians, and the wound-care nurses. Post-operative follow-up is intensive and long — this is not a one-visit pathway. The outcome we aim for is a plantigrade, infection-free, walking foot.
Yes. We see patients regularly where joint orthoplastic reconstruction can save a limb that conventional orthopaedics alone cannot. We are also honest when amputation truly is the better option — quicker, safer, and a better functional outcome with a good prosthesis.
Diabetic-foot reconstruction is measured in months, not weeks. A typical reconstruction is 3–6 months from operation to weight-bearing, sometimes longer. We will be specific about your case at the first consultation.
Foot care after the first reconstruction matters enormously — bespoke footwear, regular podiatry, tight glycaemic control. We will set this up with your team as part of the plan.
Yes — both Professor Heidari and Mr Pafitanis work in the NHS too. The pathway is different (longer, harder to coordinate), but the underlying surgery is the same.
An unhurried first consultation, a written diagnostic letter within 48 hours, and a clear sense of options — with no obligation to choose surgery on the day.
Last reviewed: by Professor Nima Heidari.
