Charcot Arthropathy of the Diabetic Foot. Current Concepts and Review of 36 Cases
| Autor: | H. Oksala, S. E. Honkonen, Toni-Karri Pakarinen, H.-J. Laine, Jorma Lahtela, J. Peltonen |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Reconstructive surgery medicine.medical_treatment Arthrodesis Triple arthrodesis 03 medical and health sciences 0302 clinical medicine Arthropathy Humans Medicine Aged Retrospective Studies 030222 orthopedics Chi-Square Distribution business.industry Incidence (epidemiology) Retrospective cohort study 030229 sport sciences Middle Aged medicine.disease Diabetic foot Diabetic Foot Surgery Casts Surgical Treatment Outcome Female Arthropathy Neurogenic business Foot (unit) |
| Zdroj: | Scandinavian Journal of Surgery. 91:195-201 |
| ISSN: | 1799-7267 1457-4969 |
| Popis: | Background and Aims:The incidence of diabetic Charcot neuroarthropathy has increased. The purpose here was to study the current diagnostics and treatment of the Charcot foot.Materials and Methods:During a time period from 1994 to 2000, a total of 36 feet were diagnosed as cases of diabetic Charcot neuroarthropathies. A retrospective analysis of patient records and radiographs was undertaken. A review of the recent literature is presented.Results:29 cases were diagnosed in the dissolution stage, 2 in coalascence, and 5 in the resolution stage. The diagnostic delay averaged 29 weeks. Treatment with cast immobilisation ranged from 4 to 37 weeks (mean 11 weeks). A total of 14 surgical procedures were carried out on 10 patients: six exostectomies, four midfoot arthrodeses, one triple arthrodesis, one tibiocalcaneal arthrodesis and two below-knee amputations. radiological fusion was achieved in two thirds of the attempted arthrodeses.Conclusions:A physician should always consider the Charcot neuroarthropathy when a diabetic patient has an inflamed foot. In the absence of fever, elevated CRP or ESR, infection is a highly unlikely diagnosis, and a Charcot process should primarily be considered. The initial treatment of an inflamed Charcot foot consists in sufficiently long non-weightbearing with a cast, which should start immediately after the diagnosis. The prerequisites of successful reconstructive surgery are correct timing, adequate fixation and a long postoperative non-weightbearing period. In the resolution stage most Charcot foot patients need custom-molded footwear. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|