ABSTRACT

Aim: To analyze the management of surgical complications encountered in upper limb in diabetic patients; being treated in surgical department at Allama Iqbal Memorial Teaching Hospital, Sialkot.

Study design: Prospective Study

Place and duration of study: Department of Surgery, Khawaja Muhammad Safdar Medical college, Sialkot from June 2016 to December 2020.

Methodology: All diabetic patients treated in surgical outpatients’ department as well as admitted patients were included in the study. The written informed consent for inclusion in the study was obtained. The patients having involvement of upper limb were followed from the time of presentation until 3 months after the treatment is over or their associated complications are managed. Both type 1 and Type 2 diabetes patients were included. The data including history, examination investigations including metabolic profile and blood glucose monitoring, diagnosis and treatment record was entered on a proforma.

Results: Out of 296 Group I patients, 46 patients have hand involvement, 115 patients have shoulder problems, 11 patients have fingers involvement, 6 patients have Dupuytren’s contracture, 16 patients have Carpal Tunnel Syndrome and 102 patients have Tendonitis at any level. Out of 126 Group II patients, 32 patients have hand involvement, 27 patients have shoulder problems, 7 patients have Dupuytren’s contracture, 29 patients have Carpal. Out of 141 Group II patients, 29 patients were managed with release of median nerve with 27 patients manipulation under anesthesia, 32 patients with debridements, 15 patients with intralesional steroid injection, 23 patients with physiotherapy/splints and 15 patients with TENS.

Conclusion: Additional research is needed to understand the unique reasons for upper extremity problems in patients with diabetes, and to identify preventative treatments.

Keywords: Type 2 Diabètes mellitus, Adhesive capsulitis, Carpal tunnel syndrome, Dupuytren’s contracture,