Tropical diabetic hand syndrome : a prospective study in Jordan

الملخص EN

Background : Diabetes mellitus is a common metabolic disorder in non-tropical countries.

Hand complications are very infrequent in comparison with foot complications.

Tropical diabetic hand syndrome has been documented in tropical countries and it is suggested that it may occur in non-tropical countries, but is seldom recorded.

Objectives : To document the presence, the causes and the mode of presentation of diabetic hand syndrome in non-tropical countries.

Methods : In the period 1st of February 2009 to the 5th of March 2010 five cases of diabetic hand syndrome were studied in Al Basher teaching hospital, Amman, Jordan.

On admission a detailed history and physical examination were undertaken.

This included fasting blood sugar estimation, deep wound swabs and plain x-rays of the affected limbs.

Results : Three of the patients were males and two were females.

Their ages ranged from 55 to 74 years, with a mean of 64.5 years.

The left hand was affected in three patients ; while the right was affected in the other two.

The clinical history of diabetes ranged from 10 to 15 years, with a mean of 11.75 years.

Three patients presented with an ulcer, one with an abscess and the other presented with gangrene.

The ring finger was affected in two patients, the middle finger in one, the palm in one and the dorsum of the hand in one patient.

More than one microorganism was isolated from all the swab cultures; however, Staphylococcus aureus was the most common organism.

Conclusion : Although it is very infrequent in non-tropical countries, diabetic hand syndrome is a devastating cause of morbidity and mortality particularly in negligent, senescent patients with poorly controlled and long standing diabetes.