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Charcot foot

Dharmadas Salini, Kumar Harish, Pillay Minnie, Karimassery R Sundaram, Bal Arun, Chirukandath J Sandya, Thacho S Mangalanandan, Lakshmanan Vivek, Valiyaparambil P Praveen
Aims: Available literature on the prevalence of Charcot arthropathy (CA) represents mainly Western population. No study has been reported from India so far. Hence we attempted to study the prevalence of CA in patients with type 2 diabetes mellitus and severe peripheral neuropathy (T2DMPN), belonging to Indian population amongst whom type 2 diabetes is on the rise in alarming proportions. Materials and Methods: Medical records of 3387 patients who performed an objective vibration perception threshold test during the year 2015 were screened for T2DMPN...
January 2018: Indian Journal of Endocrinology and Metabolism
Patrick Esser, Johnny Collett, Kevin Maynard, Dax Steins, Angela Hillier, Jodie Buckingham, Garry D Tan, Laurie King, Helen Dawes
This study explored the potential utility of gait analysis using a single sensor unit (inertial measurement unit [IMU]) as a simple tool to detect peripheral neuropathy in people with diabetes. Seventeen people (14 men) aged 63±9 years (mean±SD) with diabetic peripheral neuropathy performed a 10-m walk test instrumented with an IMU on the lower back. Compared to a reference healthy control data set (matched by gender, age, and body mass index) both spatiotemporal and gait control variables were different between groups, with walking speed, step time, and SDa (gait control parameter) demonstrating good discriminatory power (receiver operating characteristic area under the curve >0...
February 2018: Diabetes & Metabolism Journal
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
Chiara Lauri, Andor W J M Glaudemans, Alberto Signore
BACKGROUND: Diagnosing diabetic foot infection is often difficult, despite several available diagnostic methods. Amongst these, several imaging modalities exist to evaluate the diabetic foot in case of a suspected osteomyelitis. Nuclear Medicine, in particular, offers a variety of radiopharmaceuticals and techniques. Nowadays the gold standard radionuclide procedure, when an osteomyelitis is suspected, is represented by the use of radiolabelled leukocytes with either 99mTc-HMPAO or 111In-oxine...
February 26, 2018: Current Pharmaceutical Design
Rasmus Bo Jansen, Tomas Møller Christensen, Jens Bülow, Lene Rørdam, Per E Holstein, Ole Lander Svendsen
OBJECTIVE: Charcot foot is a severe complication to diabetes mellitus, associated with diabetic neuropathy. Any long-term effects of a Charcot foot on the progress of neuropathy are still largely unexplored. The objective was to investigate whether a previous Charcot foot had any long-term effects on the progress of neuropathy. RESULTS: An 8.5-year follow-up case-control study of 49 individuals with diabetes mellitus, 24 of whom also had Charcot foot at baseline visit in 2005-2007...
February 20, 2018: BMC Research Notes
M Chraim, S Krenn, H M Alrabai, H-J Trnka, P Bock
AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail...
February 2018: Bone & Joint Journal
Prashanth R J Vas, Michael Edmonds, Venu Kavarthapu, Hisham Rashid, Raju Ahluwalia, Christian Pankhurst, Nikolaos Papanas
The "diabetic foot attack" is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival...
February 1, 2018: International Journal of Lower Extremity Wounds
J W K Louwerens
The present article presents a short summary concerning the pathomechanisms and clinical presentation of foot deformities in Charcot-Marie-Tooth syndrome. Furthermore, a classification system is introduced and based on a recently performed review of the literature an operative treatment algorithm is provided. The operative technique of the following surgical procedures is described in more detail: 1. dorsiflexion osteotomy at the base of the 1st metatarsus, 2. dorsiflexion osteotomy at the base of a lesser metatarsal bone, 3...
February 7, 2018: Operative Orthopädie und Traumatologie
Francisco-J Renero-C
Background: One of the complications of the diabetes mellitus is the amputation of the lower limbs. This complication may be developed after an insidious ulcer, that may be raised by the peripheral neuropathy or the ischaemic limb, and that the ulcer get infected. That is, to develop an ulcer, in the diabetic patient, three factors should be taken into the account, the autonomic nervous system, the blood supply and the inmune system. Methods: In this work, the thermogram is used to identify regions on the plantar skin with blood supply deficiencies and the behaviour of the thermoregulation process...
2018: Diabetic Foot & Ankle
Moses Lee, Woo Jin Choi, Seung Hwan Han, Jinyoung Jang, Jin Woo Lee
BACKGROUND: Tibiotalocalcaneal (TTC) fusion using a retrograde intramedullary (IM) nail is an effective salvage option for terminal-stage hindfoot problems. However, as many patients who receive TTC fusion bear unfavorable medical comorbidities, the risk of nonunion, infection and other complications increases. This study was performed to identify the factors influencing outcomes after TTC fusion using a retrograde IM nail. METHODS: Between September 2008 and February 2012, 34 consecutive patients received TTC fusion using a retrograde IM nail for limb salvage...
July 22, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
N Vasukutty, H Jawalkar, A Anugraha, R Chekuri, R Ahluwalia, V Kavarthapu
BACKGROUND: Corrective fusion for the unstable deformed hind foot and mid foot in Charcot Neuroarthropathy (CN) is quite challenging and is best done in tertiary centres under the supervision of multidisciplinary teams. METHODS: We present a follow up to our initial report with a series of 42 hind foot corrections in 40 patients from a tertiary level teaching hospital in the United Kingdom. The mean patient age was 59 (33-82). 17 patients had type1diabetes mellitus, 23 had type 2...
April 28, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Hamad Almuhannadi, Georgios Ponirakis, Adnan Khan, Rayaz Ahmed Malik
The most common and debilitating microvascular complication of diabetes is diabetic peripheral neuropathy (DPN), affecting 50-90% of people with diabetes. The major manifestations of DPN are painful (pDPN) and painless diabetic peripheral neuropathy. Painful symptoms, occur in the feet and are worse at night and whilst they alert both the patient and physician, are often misdiagnosed and mismanaged. The devastating presentation of painless neuropathy with loss of sensation is foot ulceration and Charcot foot...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Tun Hing Lui
Tarsometatarsal (Lisfranc) destruction of the tarsometatarsal articulation of the lesser rays is most commonly due to midfoot Charcot neuroarthropathy. Tarsometatarsal arthrodesis is indicated when conservative management cannot relieve the symptoms. The purpose of this Technical Note is to describe a minimally invasive approach of arthroscopic arthrodesis of the destructed lesser ray tarsometatarsal joints. The arthroscopic procedure is performed through the lateral and P1-2 Lisfranc portals. It has the advantages of better cosmesis, less wound complication, less bone resection, and more thorough joint debridement...
October 2017: Arthroscopy Techniques
Reed Mitchell, Jeremy Molligan, Sydney Rooney, Young Cho, Lew Schon, Zijun Zhang
Charcot neuroarthropathy (CNA) often presents as a diabetic foot complication. The role of synovial mesenchymal stem cells (syn-MSCs) in the pathogenesis of CNA is unclear. Synovial samples were collected, for isolation of syn-MSCs, from diabetic patients with CNA (n=7) and non-diabetic patients with intra-articular fracture or normal joints (non-CNA; n=7) during foot surgery. The syn-MSCs in the CNA and non-CNA groups were characterized comparatively. The average number of colonies formed in the CNA group was 6±3...
January 15, 2018: Experimental and Molecular Pathology
Fredrik A Nilsen, Marius Molund, Kjetil H Hvaal
Few studies have evaluated the long-term clinical outcomes of Charcot foot. The present study evaluated the long-term effects of Charcot foot in a population treated with early weightbearing in a removable Charcot restraint orthotic walker. A retrospective study of 62 consecutive patients (74 feet) treated for Charcot foot from January 2003 to March 2014 was conducted. Of the 74 affected feet, 48 (64.9%) had developed an ulcer. The total amputation rate was 25.7% (19 feet), and 11 feet (14.9%) underwent major amputations...
January 5, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Gita M Ramdharry, Louise Reilly-O'Donnell, Robert Grant, Mary M Reilly
OBJECTIVE: People with Charcot-Marie-Tooth (CMT) disease may be at risk of falls due to distal muscle weakness and sensory impairment. We aimed to understand the frequency of falls in a cohort, where they occurred, injury and to what people attributed the possible cause. DESIGN: A cross-sectional survey design was used. It was sent by post to ascertain the frequency of falls and near falls, plus the circumstances of the last three falls events they could recall...
December 28, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Youngrak Choi, Young-Woo Kwon, Young-Suk Sim, Taeho Kim, Dayoung Song, Soohyun Lee
BACKGROUND: Calcaneal insufficiency avulsion (CIA) fractures often present with neuropathic etiology, such as Charcot neuroarthropathy (CN). Under the same surgical procedures, the outcomes of CIA fractures are less desirable, compared to the outcomes of the traumatic calcaneal avulsion fractures. Here, the study suggests Achilles tenodesis technique using suture anchor after resection of the CIA fracture fragments could provide satisfactory clinical results in the cases of surgically indicated CIA fractures...
December 13, 2017: Journal of Orthopaedic Surgery and Research
L Meacock, N L Petrova, Ana Donaldson, A Isaac, A Briody, R Ramnarine, M E Edmonds, D A Elias
There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0-no oedema, 1-oedema < 50% of bone volume, and 2-oedema > 50% of bone volume) and fracture (0-no fracture, 1-fracture, and 2-collapse/fragmentation)...
2017: Journal of Diabetes Research
Rasmus Bo Jansen, Tomas Møller Christensen, Jens Bülow, Lene Rørdam, Per E Holstein, Niklas Rye Jørgensen, Ole Lander Svendsen
BACKGROUND AND AIMS: Charcot foot is a rare but severe complication to diabetes and peripheral neuropathy. It is still unclear if an acute Charcot foot has long-term effects on the bone metabolism. To investigate this, we conducted a follow-up study to examine if a previously acute Charcot foot has any long-term effects on bone mineral density (BMD) or local or systemic bone metabolism. METHODS: An 8.5-year follow-up case-control study of 44 individuals with diabetes mellitus, 24 of whom also had acute or chronic Charcot foot at the baseline visit in 2005-2007, who were followed up in 2015 with DXA scans and blood samples...
February 2018: Journal of Diabetes and its Complications
A Haep, S Murday, A Risse, D Nashan, H F Ständer
Charcot foot is also known as Charcot disease or Charcot arthropathy. The associated aseptic destruction of the bones and joints of the foot results due to peripheral neuropathy accompanied by impaired pain perception, impaired vasomotricity with increased vasodilation, and an unequal weight distribution. Because it is frequently diagnosed late and, thus, incorrectly treated, serious complications often result. An 86-year-old man in poor health was diagnosed with erysipelas of the right foot. The foot was glossy and edematously swollen, showing necrosis of the distal phalanx of the third toe...
November 28, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
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