An overview of the Charcot foot pathophysiology.
Authors: Kaynak G, Birsel O, Güven MF, Oğüt T
Abstract
Charcot arthropathy of the foot is a rare but devastating complication of diabetes that remains to be a challenging issue for the foot and ankle surgeons. Charcot foot fails to be an obvious diagnostic option that comes to mind, even in a pathognomonic clinical appearance. The rarity of the disorder, more common pathologies that mimic the condition, and the self-limiting prognosis deviate the clinician from the right diagnosis. The clinical challenges in the diagnosis of Charcot foot require in-depth investigations of its enigmatic nature to establi...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Conservative and surgical treatment of the chronic Charcot foot and ankle.
Authors: Güven MF, Karabiber A, Kaynak G, Oğüt T
Abstract
Charcot neuroarthropathy (CN) is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, and limb loss. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus. The aim of this manuscript was to evaluate modern concepts of chronic CN through a review of the available literature and to integrate a perspective of management from the authors' extensive experience.
PMID: 23919114 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Charcot neuroarthropathy in simultaneous kidney-pancreas transplantation: report of two cases.
Authors: Del Vecchio JJ, Raimondi N, Rivarola H, Autorino C
Abstract
Charcot neuroarthropathy (CN) is considered a major complication in diabetes mellitus (DM), and it is estimated that 1% of diabetic patients may develop this complication. Simultaneous kidney-pancreas transplantation (SKPT) is one of the most effective therapies for patients with type 1 DM and end-stage diabetic nephropathy. Some cases with a Charcot-modified clinical presentation during the postoperative convalescence period after SKPT have been described. The clinical presentation may condition severe destructive lesions, and good pract...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
An analysis of clinical activity, admission rates, length of hospital stay, and economic impact after a temporary loss of 50% of the non-operative podiatrists from a tertiary specialist foot clinic in the United Kingdom.
CONCLUSIONS: Our data suggest that specialist non-operative podiatrists involved in the treatment of the diabetic foot may prevent unwarranted hospital admission and increased hospitalisation rates by providing skilled assessment and care in the outpatient clinical settings.
PMID: 24040488 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Electrical stimulation to accelerate wound healing.
CONCLUSION: Electrical stimulation has been shown to accelerate wound healing and increase cutaneous perfusion in human studies. Electrical stimulation is an adjunctive therapy that is underutilized in plastic surgery and could improve flap and graft survival, accelerate postoperative recovery, and decrease necrosis following foot reconstruction.
PMID: 24049559 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Relative sensory sparing in the diabetic foot implied through vibration testing.
CONCLUSION: This study confirms the hallux as the most appropriate location for vibration testing and implies relative sensory sparing at the 5th metatarsal head, a finding not previously reported in diabetic patients.
PMID: 24049560 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Negative-pressure wound therapy in the management of diabetic Charcot foot and ankle wounds.
Authors: Ramanujam CL, Stapleton JJ, Zgonis T
Abstract
As the prevalence of diabetes mellitus continues to rise, innovative medical and surgical treatment options have increased dramatically to address diabetic-related foot and ankle complications. Among the most challenging clinical case scenarios is Charcot neuroarthropathy associated with soft tissue loss and/or osteomyelitis. In this review article, the authors present a review of the most common utilizations of negative-pressure wound therapy as an adjunctive therapy or combined with plastic surgery as it relates to the surgical management of diabetic...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Charcot foot and ankle with osteomyelitis.
Authors: Donegan R, Sumpio B, Blume PA
Abstract
This paper presents a review of the current literature discussing topics of Charcot osteoarthropathy, osteomyelitis, diagnosing osteomyelitis, antibiotic management of osteomyelitis, and treatment strategies for management of Charcot osteoarthropathy with concurrent osteomyelitis.
PMID: 24098835 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
The system of care for the diabetic foot: objectives, outcomes, and opportunities.
Authors: Barshes NR, Sigireddi M, Wrobel JS, Mahankali A, Robbins JM, Kougias P, Armstrong DG
Abstract
Most cases of lower extremity limb loss in the United States occur among people with diabetes who have a diabetic foot ulcer (DFU). These DFUs and the associated limb loss that may occur lead to excess healthcare costs and have a large negative impact on mobility, psychosocial well-being, and quality of life. The strategies for DFU prevention and management are evolving, but the implementation of these prevention and management strategies remains challenging. Barriers to implementation include poor access...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
A developing world experience with distal foot amputations for diabetic limb salvage.
CONCLUSION: With the ever-increasing epidemic of DM, the number of patients with diabetic foot ulcers has also significantly risen. Early surgical management with good glycemic control and foot care with close monitoring can decrease amputations and thus foot salvage can be successfully achieved.
PMID: 24155996 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Radiographic and functional results in the treatment of early stages of Charcot neuroarthropathy with a walker boot and immediate weight bearing.
CONCLUSION: The treatment of early stages of CN (Eichenholtz stages I and II) with emphasis on walker boot and immediate weight bearing has shown a good functional outcome, non-progressive deformity on radiographic assessment, and promising results as a safe treatment option.
PMID: 24179634 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Osteomyelitis or Charcot neuro-osteoarthropathy? Differentiating these disorders in diabetic patients with a foot problem.
Authors: Ertugrul BM, Lipsky BA, Savk O
Abstract
Both osteomyelitis and Charcot neuro-osteoarthropathy (CN) are potentially limb-threatening complications of diabetic neuropathy, but they require quite different treatments. Almost all bone infections in the diabetic foot originate from an infected foot ulcer while diabetic osteoarthropathy is a non-infectious process in which peripheral neuropathy plays the critical role. Differentiating between diabetic foot osteomyelitis and CN requires careful evaluation of the patient, including the medical history, physical examination, selected laboratory findings, a...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Charcot foot in diabetes and an update on imaging.
This study focuses on imaging findings of acute and chronic neuropathic osteoarthropathy in diabetes and discrimination of infected vs. non-infected neuropathic osteoarthropathy.
PMID: 24273635 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Early results from an angiosome-directed open surgical technique for venous arterialization in patients with critical lower limb ischemia.
CONCLUSION: Venous arterialization may be used as a treatment of otherwise unsalveable limbs. The success rate is, however, limited. Technical optimization of the technique is warranted.
PMID: 24358432 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Combined use of Ilizarov external fixation and Papineau technique for septic pseudoarthrosis of the distal tibia in a patient with diabetes mellitus.
Authors: Koutsostathis SD, Lepetsos P, Polyzois VD, Pneumaticos SG, Macheras GA
Abstract
The surgical treatment of open pilon fractures has a high complication rate especially in diabetic patients. In this article, we present a case of an infected tibial non-union after an open reduction and internal fixation in a diabetic patient, treated with Ilizarov external fixation combined with Papineau technique. Combined use of external fixation and Papineau technique can provide an alternative option for the treatment of septic pseudoarthrosis of the distal tibia.
PMID: 24563728 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
