Extension and grading of osteomyelitis are not related to limb salvage in Charcot neuropathic osteoarthropathy: A cohort prospective study

Autor: Giulio Boscarino, Anna Carone, Luca Dalla Paola, Lucian Vasilache, Marco Baglioni
Rok vydání: 2016
Předmět:
Male
Time Factors
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Severity of Illness Index
Cohort Studies
0302 clinical medicine
Endocrinology
Spinal osteoarthropathy
Charcot foot
Prospective Studies
Prospective cohort study
030222 orthopedics
education.field_of_study
Foot infection
Osteomyelitis
Bacterial Infections
Middle Aged
Limb Salvage
Prognosis
Diabetic Foot
Diabetes and Metabolism
medicine.anatomical_structure
Italy
Disease Progression
Female
medicine.symptom
Type 2
Type 1
medicine.medical_specialty
Population
Diabetic foot surgery
030209 endocrinology & metabolism
NO
03 medical and health sciences
Foot Joints
Osteoarthritis
Diabetes Mellitus
Internal Medicine
medicine
Deformity
Humans
education
Aged
Foot ulcer
business.industry
Recovery of Function
medicine.disease
Surgery
Diabetes Mellitus
Type 1
Diabetes Mellitus
Type 2
Follow-Up Studies
Amputation
Ankle
Complication
business
Zdroj: Journal of Diabetes and its Complications. 30:608-612
ISSN: 1056-8727
DOI: 10.1016/j.jdiacomp.2016.02.012
Popis: Aims Charcot neuropathic osteoarthropathy (CN) represents a complication for diabetic patients which involves a progressive alteration of the osteoarticular apparatus with high risk of amputation. The aim of the study was to assess whether the localization of CN and the extent or grading of the osteomyelitis have an influence on the rate of limb salvage and the time to recovery. Methods We treated a diabetic population affected by CN complicated by ulceration and widespread osteomyelitic involvement. All patients were treated surgically to eliminate infected tissues, stabilize and correct the bone deformities. Histopathological and microbiological analyses were carried out on the bone specimens. Results Thirty-three patients affected by CN complicated by large osteomyelitic involvement of midfoot and/or ankle were treated between January 2010 and May 2014. The mean follow-up was 409,35 ± 154,06 days. Thirty patients had complete recovery (90.91%) at the end of follow-up. No difference in limb salvage rate and time to recovery was observed when stratifying the population according to CN localization, extent and grading of osteomyelitis. Conclusions In this cohort prospective study we observed a high percentage of limb salvage in patients affected by CN complicated by diffuse midfoot/hindfoot osteomyelitis. The localization of Charcot deformity and the extent/stage of osteomyelitis did not change the rate of limb salvage.
Databáze: OpenAIRE
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