Charcot foot (neuropathic arthropathy) in diabetes as a "special needs foot". Case report of an efficient negative pressure wound therapy use.
Diabetes is the most common endocrine disorder of carbohydrate metabolism. If left untreated, or improperly treated for many years, diabetes leads to multiple organ complications. One of the serious consequences of the disease is damage to the peripheral and autonomic nerves known as diabetic neuropathy. The most advanced form of neuropathy, leading to damage to the structures of the forefoot, midfoot and hindfoot, is the so called Charcot foot, or neuropathic osteoarthropathy. Irreversible damage to the structures of the foot affects between 0,1% and 7.5% of patients with diabetes.
The optimal care for that form of foot damage is still a subject to debate. Available methods of caring for Charcot foot include invasive orthopedic treatment and conservative treatment. The use of negative pressure woudn therapy may be an effective, as well as transitional, way of managing Charcot foot.
International Diabetes Federation. World Diabetes Congress Dubai, 4 December to 8 December 2011. Available from: http://www.idf.org.
Charcot J. Sur quelques arthropathies qui paraissent dependre d’une lesion du cerveau ou de la moelle epiniere. Arch Des Phys Norm Pathol 1868; 1: 161.
Gouveri E, Papanas N. Charcot osteoarthropathy in diabetes: a brief review with an emphasis on clinical practice. World J Diabetes 2011; 2: 59-65. doi: 10.4239/wjd.v2.i5.59.
Malhotra S, Bello E, Kominsky S. Diabetic foot ulcerations: biomechanics, charcot foot, and total contact cast. Semin Vasc Surg 2012; 25: 66-9. doi: 10.1053/j.semvascsurg.2012.05.001.
Petrova NL, Moniz C, Elias DA, Buxton-Thomas M, Bates M, Edmonds ME. Is there a systemic inflammatory response in the acute charcot foot? Diabetes Care 2007; 30: 997-8. doi: 10.2337/dc06-2168
Eichenholtz SN. Charcot joints. With a foreword by P.D.Wilson. Springfield (Ill): Charles C. Thomas; 1966.
Chisholm KA, Gilchrist JM. The Charcot joint: a modern neurologic perspective. J Clin Neuromuscul Dis 2011; 13: 1-13. doi: 10.1097/CND.0b013e3181c6f55b.
Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007; 115: 387-97.
Gilbey SG, Walters H, Edmonds ME, Archer AG, Watkins PJ, Parsons V, et al. Vascular calcification, autonomic neuropathy, and peripheral blood flow in patients with diabetic nephropathy. Diabet Med 1989; 6: 37-42. doi: 10.1111/j.1464-5491.1989.tb01136.x
Watkins PJ. Foot blood flow in diabetic neuropathy. J R Soc Med 1983; 76: 996.
Watkins PJ, Edmonds ME. Sympathetic nerve failure in diabetes. Diabetologia 1983; 25: 73-7.
Purewal TS, Goss DE, Watkins PJ, Edmonds ME. Lower limb venous pressure in diabetic neuropathy. Diabetes Care 1995; 18: 377-81. doi: 10.2337/diacare.18.3.377
Young MJ, Marshall A, Adams JE, Selby PL, Boulton AJ. Osteopenia, neurological dysfunction, and the development of Charcot neuroarthropathy. Diabetes Care 1995; 18: 34-8. doi: 10.2337/diacare.18.1.34
Petrova NL, Foster AV, Edmonds ME. Calcaneal bone mineral density in patients with Charcot neuropathic osteoarthropathy: differences between Type 1 and Type 2 diabetes. Diabet Med 2005; 22: 756-61. doi: 10.1111/j.1464-5491.2005.01510.x
Grant WP, Sullivan R, Sonenshine DE, Adam M, Slusser JH, Carson KA, et al. Electron microscopic investigation of the effects of diabetes mellitus on the Achilles tendon. J Foot Ankle Surg 1997; 36: 272-8. doi:10.1016/S1067-2516(97)80072-5
Rajbhandari SM, Jenkins RC, Davies C, Tesfaye S. Charcot neuroarthropathy in diabetes mellitus. Diabetologia 2002; 45(8): 1085-96. doi: 10.1007/s00125-002-0885-7
Sanders LJ, Frykberg RG. Diabetic neuropathic osteoarthropathy: the Charcot foot. In: Frykberg RG, ed. The high risk foot in diabetes mellitus. New York: Churchill Livingstone; 1991, pp. 297 - 338.
Assal M, Stern R. Realignment and extended fusion with useof a medial column screw for midfoot deformities secondaryto diabetic neuropathy. J Bone Joint Surg Am 2009; 91(4): 812–20. doi: 10.2106/JBJS.G.01396.
Pakarinen TK, Laine HJ, Honkonen SE, Peltonen J, Oksala H, Lahtela J. Charcot arthropathy of the diabetic foot. Current concepts and review of 36 cases. Scand J Surg 2002; 91: 195-201.
Sellés Dechent R, Rueda Alcárcel C, Primo Romaguera V, Martínez Caamaño A, Asencio Arana F. Role of the General Surgeon in the Early Diagnosis and Treatment of Charcot Foot. Cir Esp 2015; 93(5): 320-5. doi: 10.1016/j.ciresp.2013.04.027
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