Background: Charcot foot is a severe complication of diabetes mellitus. Amputation is associated with 5-year mortality rates as high as 70%, and the overall treatment cost for diabetic foot surpasses that of conditions such as cancer or depression. Objectives: To compare clinical, quality-of-life, and cost outcomes related to Charcot foot management through two distinct treatments: amputation and resection with stabilization using circular external fixation (CEF). Methods: This retrospective study included all adult patients treated at our unit between 2008 and 2022 for acute diabetic foot with infected ulcers. The allocation to treatment groups was based on the timing of patient enrollment. We gathered anthropometric, diagnostic, and surgical data, documenting individualized costs for preoperative, postoperative, and rehabilitation phases. Health status was assessed using the EQ-5D-3L questionnaire, and recorded data included mortality. Results: A total of 31 patients (18 amputations; 13 CEF) were included. Amputees exhibited significantly higher mortality compared to those with a CEF (44.8% vs 7.7%, p = 0.045). The estimated 3-year survival was 60.8% for amputees and 90% for the CEF group (log-rank test, p = 0.096). In terms of quality of life (EQ-5D-3L), amputees reported a reduction of 14.67 points while CEF patients reported an increase of 40.39 points ( p < 0.001). The EQ-5D-3L index improved by 1.8 points for amputees, as compared with 62.3 points in the CEF group ( p < 0.001). The total mean cost of managing an amputated patient was €222,864, practically identical to the €224,438 incurred in the CEF group ( p = 0.767). No statistically significant differences were found in the time distribution of costs. However, some specific expense items demonstrated statistical significance. Conclusion: In treating infected diabetic foot ulcers, external fixation leads to a better quality of life compared to amputation. There’s also a trend suggesting higher survival rates with external fixation, and both approaches have similar costs.

Antecedentes: La medición del resultado posterior a la cirugía, típicamente se basa en resultados radiológicos postoperatorios y escalas clínico-funcionales; sin embargo, en la actualidad hay un creciente interés por considerar al grado de satisfacción del paciente (que incluyen aspectos subjetivos) como parte del éxito de la cirugía de antepié. Objetivo: Determinar si el mostrar una fotografía de la apariencia preoperatoria mejora la satisfacción en pacientes postoperados de antepié. Materiales y métodos: Se realizó un estudio observacional, transversal, analítico, en la Unidad de Pie y Tobillo de nuestro centro. Se incluyeron 120 participantes entre 18 y 90 años, que fueron sometidos a cirugía de antepié. Se comparó el grado de satisfacción mediante el cuestionario PSQ-10 entre un grupo de pacientes que recibió, en su control postoperatorio a los 3 meses, una imagen del aspecto preoperatorio del pie y aquellos que no la recibieron. Resultados: El grado de satisfacción total fue de 78,33% a los 3 meses de la intervención. El 93,6% de los pacientes que recibieron la fotografía, estaban satisfechos en el control postoperatorio, mientras que en el grupo control fue de 86,2 % con una p= 0.218. Conclusión: El grado de satisfacción en pacientes sometidos a cirugía de antepié no está asociado a la presentación de la fotografía preoperatoria. Background: Postoperative outcome measurement typically relies on postoperative radiological results and clinical-functional scales; however, there is a growing interest in considering patient satisfaction (including subjective aspects) as part of the success of forefoot surgery. Objective: To determine whether showing a preoperative photograph improves satisfaction in postoperative forefoot surgery patients. Material and Methods: An observational, cross-sectional, analytical study was conducted in the Foot and Ankle Unit of our center. We included 120 participants between 18 and 90 years old who underwent forefoot surgery. The degree of satisfaction was compared using the PSQ-10 questionnaire between a group of patients who received a preoperative foot appearance image at their 3-month postoperative follow-up and those who did not receive it. Results: The overall satisfaction rate was 78.33% at 3 months after the intervention. The 93.6% of patients who received the photograph were satisfied at the postoperative follow-up, while in the control group, it was 86.2% with a p-value of 0.218. Conclusion: The degree of satisfaction in patients undergoing forefoot surgery is not associated with the presentation of preoperative photographs.