Objective
The purpose of this study was to describe the use of dermal fillers in the treatment of large, soft-tissue defects in diabetic foot with and without the use of external fixation of the foot.
Patients and methods
Thirteen patients with chronic nonhealing diabetic foot ulcer for several weeks to months were included in the study. There were 11 male and two female patients. Seven patients (three female and four male) were randomly assigned to the Botox injection group, and six patients (four female and two male) were randomly assigned to the external fixator group. The mean ± SD age of patients was 55 ± 10 years.
Results
At 12 weeks, the proportion of healing was significantly higher in the Botox with an external frame group than in the Botox alone group (89.5 vs. 61.4%,  = 0.026). At final follow-up, 12 (92.3%) patients were ambulatory with a regular or custom shoe and had a good result based on our defined criteria. There were no complications from the injections.
Conclusion
The use of Botox together with an external fixator is an attractive choice to off-load diabetic foot ulcer.