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Charcot foot

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https://www.readbyqxmd.com/read/28448704/-retrograde-intramedullary-nail-fixation-for-charcot-neuroarthropathy
#1
E López-Gavito, N A Gómez-Fuentes, P Parra-Téllez, M Lezama-Peniche, J Vázquez-Escamilla, S R León-Hernández
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28448691/clinical-characterization-and-genetic-analysis-of-korean-patients-with-x-linked-charcot-marie-tooth-disease-type-1
#2
Young Bin Hong, Jin-Mo Park, Jin Seok Yu, Da Hye Yoo, Da Eun Nam, Hyung Jun Park, Ji-Su Lee, Sun Hee Hwang, Ki Wha Chung, Byung-Ok Choi
Mutations in the gap junction protein beta 1 gene (GJB1) cause X-linked Charcot-Marie-Tooth disease type 1 (CMTX1). CMTX1 is representative of the intermediate type of CMT, having both demyelinating and axonal neuropathic features. We analyzed the clinical and genetic characterization of 128 patients with CMTX1 from 63 unrelated families. Genetic analysis revealed a total of 43 mutations including 6 novel mutations. Ten mutations were found from two or more unrelated families. p.V95M was most frequently observed...
April 27, 2017: Journal of the Peripheral Nervous System: JPNS
https://www.readbyqxmd.com/read/28440774/diagnostic-and-therapeutic-update-on-diabetic-foot-osteomyelitis
#3
José Luis Lázaro-Martínez, Aroa Tardáguila-García, José Luis García-Klepzig
Diabetic foot osteomyelitis (DFO) is the most common infection associated to diabetic foot ulcers (DFU). This review is designed to provide an update on the diagnosis and treatment of DFO based on an analysis of MEDLINE through PubMed using as search criterion "Diabetic Foot Osteomyelitis". Authors have included in this review the most relevant manuscripts regarding diagnosis and treatment of DFO. After review and critical analysis of publications, it may be concluded that diagnosis of DFO is not simple because of its heterogeneous presentation...
February 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28397549/functional-impairment-of-patients-undergoing-surgical-correction-for-charcot-foot-arthropathy
#4
Ellen Kroin, Adam Schiff, Michael S Pinzur, Elissa S Davis, Edwin Chaharbakhshi, Frank A DiSilvio
BACKGROUND: Investigations using the Medical Outcomes Study Short Form 36 Healthy Survey (SF-36) and the American Orthopaedic Foot & Ankle Society Diabetic Foot Questionnaire (AOFAS-DFQ) have demonstrated a poor quality of life in patients with Charcot foot arthropathy. The Short Musculoskeletal Function Assessment (SMFA) questionnaire has been widely used in patients with a broad range of musculoskeletal disorders. METHODS: Twenty-five consecutive patients undergoing operative correction for diabetes-related Charcot foot arthropathy of the midfoot completed the SMFA prior to undergoing surgery...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28379183/rapid-identification-of-pathogenic-variants-in-two-cases-of-charcot-marie-tooth-disease-by-gene-panel-sequencing
#5
Chi-Chun Ho, Shuk-Mui Tai, Edmond Chi-Nam Lee, Timothy Shin-Heng Mak, Timothy Kam-Tim Liu, Victor Wai-Lun Tang, Wing-Tat Poon
Charcot-Marie-Tooth disease (CMT) is a common inherited peripheral neuropathy affecting up to 1 in 1214 of the general population with more than 60 nuclear genes implicated in its pathogenesis. Traditional molecular diagnostic pathways based on relative prevalence and clinical phenotyping are limited by long turnaround time, population-specific prevalence of causative variants and inability to assess multiple co-existing variants. In this study, a CMT gene panel comprising 27 genes was used to uncover the pathogenic mutations in two index patients...
April 5, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28356555/prevalence-of-polymorphisms-in-opg-rankl-and-rank-as-potential-markers-for-charcot-arthropathy-development
#6
Bożena Bruhn-Olszewska, Anna Korzon-Burakowska, Grzegorz Węgrzyn, Joanna Jakóbkiewicz-Banecka
Charcot arthropathy is one of the most serious complications of diabetic foot syndrome that leads to amputation of the affected limb. Since there is no cure for Charcot arthropathy, early diagnosis and implementation preventive care are the best available treatment. However, diagnosis is hindered by obscure clinical picture of the disease and lack of molecular markers for its early detection. Results of recent research suggest that OPG-RANKL-RANK axis regulating bone metabolism can be associated with Charcot arthropathy and that SNPs in OPG gene are associated with the disease...
March 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28336046/charcot-arthropathy-versus-osteomyelitis-evaluation-and-management
#7
REVIEW
John Womack
Charcot arthropathy of the foot and ankle is a severe complication of peripheral neuropathy and is most commonly seen in the developed world in association with diabetes mellitus. Correct diagnosis and differentiation from osteomyelitis of the foot and ankle are critical to guide treatment. It can exist concomitantly with osteomyelitis, typically in the setting of an advanced midfoot ulcer. Simple plain radiographs and contrasted MRI studies often yield inconclusive or confusing data. Correct use of imaging studies and a clinical algorithm can be effective tools to help make accurate and early diagnoses and guide clinical interventions for these conditions...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28325064/diabetic-foot-complications-despite-successful-pancreas-transplantation
#8
Dong-Kyo Seo, Ho Seong Lee, Jungu Park, Chang Hyun Ryu, Duck Jong Han, Sang Gyo Seo
BACKGROUND: It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. METHODS: This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28264542/a-case-series-study-on-the-efficacy-of-functional-surgery-associated-with-early-intensive-rehabilitation-therapy-in-charcot-marie-tooth-type-1a-disease
#9
Francesco Ferraro, Barbara Dusina, Irene Carantini, Roberto Strambi, Emanuela Galante, Luca Gaiani
BACKGROUND: Charcot-Marie-Tooth (CMT) is a genetically and clinically heterogeneous disorder, and it is caused by alterations in genes with different loci that encode for proteins, resulting into metabolic and structural defects. The most common form of the disease is CMT1A. Treatment of the disease, due to the absence of an effective pharmacological therapy, mainly relies on surgical treatment and rehabilitative therapy. However, the Literature is still poor of evidences on this subject...
March 6, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28257680/surgical-correction-of-the-achilles-tendon-for-diabetic-foot-ulcerations-and-charcot-neuroarthropathy
#10
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Achilles tendon pathologic conditions are implicated in contributing to the development of many diabetic foot complications including diabetic foot ulceration and Charcot neuroarthropathy. Surgical correction of the diabetic equinus deformity has been studied as an isolated or adjunctive treatment when dealing with difficult-to-close diabetic foot ulcerations or when surgically addressing the diabetic Charcot neuroarthropathy foot or ankle. This article reviews the most common indications, complications, and surgical procedures for equinus correction by either a tendo-Achilles lengthening or gastrocnemius recession for the management of diabetic foot conditions...
April 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28254346/persistent-inflammation-with-pedal-osteolysis-1year-after-charcot-neuropathic-osteoarthropathy
#11
David R Sinacore, Kathryn L Bohnert, Kirk E Smith, Mary K Hastings, Paul K Commean, David J Gutekunst, Jeffrey E Johnson, Fred W Prior
AIMS: To determine local and systemic markers of inflammation and bone mineral density (BMD) in the foot and central sites in participants with diabetes mellitus and peripheral neuropathy (DMPN) with and without acute Charcot neuropathic osteoarthropathy (CN). METHODS: Eighteen participants with DMPN and CN and 19 participants without CN had foot temperature assessments, serum markers of inflammation [C-reactive protein, (CRP) and erythrocyte sedimentation rate, (ESR)] and BMD of the foot, hip and lumbar spine at baseline and 1year follow-up...
February 14, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28236508/phenotypical-features-of-a-new-dominant-gdap1-pathogenic-variant-p-r226del-in-axonal-charcot-marie-tooth-disease
#12
Tania García-Sobrino, Patricia Blanco-Arias, Francesc Palau, Carmen Espinós, Laura Ramirez, Anna Estela, Beatriz San Millán, Manuel Arias, María-Jesús Sobrido, Julio Pardo
There are few reports on axonal CMT due to dominant GDAP1 mutations. We describe two unrelated Spanish families with a dominant axonal CMT. A novel in frame GAA deletion in exon 5 of the GDAP1 gene (c.677_679del; p.R226del) was identified in both families. Disease onset varied from early childhood to adulthood. Affected family members complained of distal lower limb weakness, cramps and foot deformities with variable CMTNS score in both families. Several individuals were asymptomatic or had paraesthesia only, however neurological examination and nerve conduction studies demonstrated neuropathic signs...
January 17, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28231964/ilizarov-external-fixator-versus-retrograde-intramedullary-nailing-for-ankle-joint-arthrodesis-in-diabetic-charcot-neuroarthropathy
#13
Barakat ElAlfy, Ayman M Ali, Sallam I Fawzy
Charcot neuroarthropathy of the ankle joint is a destructive process that leads to instability and significant morbidity that can end with amputation. Surgical arthrodesis in Charcot neuroarthropathy has a high failure rate. The aim of the present prospective study was to compare the outcomes of an Ilizarov external fixator and retrograde intramedullary nailing (IMN) for tibiotalar arthrodesis in Charcot neuroarthropathy. From February 2010 to October 2013, 27 patients (16 males and 11 females) with Charcot neuropathy of the ankle joint were treated in our department...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28222170/biomechanical-investigation-of-two-plating-systems-for-medial-column-fusion-in-foot
#14
Paul Simons, Theresia Sommerer, Ivan Zderic, Dieter Wahl, Mark Lenz, Hristo Skulev, Matthias Knobe, Boyko Gueorguiev, R Geoff Richards, Kajetan Klos
BACKGROUND: Arthrodesis of the medial column (navicular, cuneiform I and metatarsal I) is performed for reasons such as Charcot arthropathy, arthritis, posttraumatic reconstruction or severe pes planus. However, the complication rate is still high and mainly resulting from inadequate fixation. Special plates, designed for medial column arthrodesis, seem to offer potential to reduce the complication rate. The aim of this study was to investigate biomechanically plantar and dorsomedial fusion of the medial column using two new plating systems...
2017: PloS One
https://www.readbyqxmd.com/read/28159052/complex-ankle-arthrodesis-with-step-cut-osteotomy-in-charcot-arthropathy-with-bone-loss
#15
Sean Booth, Moez Ballal, Anand Pillai
We report a case of a complex limb salvage ankle arthrodesis in a patient with Charcot arthropathy. A step-cut osteotomy was performed in order to tackle the issues of anterior tibial bone loss; worsening leg length discrepancy; soft tissue contraction; joint instability and high risk of non-union. The construct formed by the step-cut allowed for the preservation of good bone stock; avoidance of further limb shortening; increased torsional stability and increased surface area for bony union. This resulted in a patient with a stable, plantigrade foot appropriate for footwear...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28120507/effect-of-systemic-insulin-treatment-on-diabetic-wound-healing
#16
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Gregory L Moneta, Amir F Azarbal
This study investigates if different diabetic treatment regimens affect diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a nonhealing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics, and outcome were collected. Nonhealing wound was defined as major or minor amputation or those who did not have complete healing until the last observation...
January 24, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28110796/effectiveness-of-hindfoot-arthrodesis-by-stable-internal-fixation-in-various-eichenholtz-stages-of-neuropathic-ankle-arthropathy
#17
Silvampatty R Sundararajan, Kanchana P Srikanth, Handenahally S Nagaraja, Shanmuganathan Rajasekaran
The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28093260/shear-and-pressure-under-the-first-ray-in-neuropathic-diabetic-patients-implications-for-support-of-the-longitudinal-arch
#18
Brian Davis, Mariam Crow, Visar Berki, Daniela Ciltea
OBJECTIVE: To assess dynamic arch support in diabetic patients at risk for Charcot neuroarthopathy whose arch index has not yet shown overt signs of foot collapse. METHODS: Two indirect measures of toe flexor activation (ratios: peak hallux pressure to peak metatarsal pressure - Ph/Pm; peak posterior hallux shear to peak posterior metatarsal shear - Sh/Sm) were obtained with a custom built system for measuring shear and pressure on the plantar surface of the foot during gait...
December 29, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28063088/mosaicism-for-a-pathogenic-mfn2-mutation-causes-minimal-clinical-features-of-cmt2a-in-the-parent-of-a-severely-affected-child
#19
Katherine Schon, Olivera Spasic-Boskovic, Kim Brugger, Tracey D Graves, Stephen Abbs, Soo-Mi Park, Gautam Ambegaonkar, Ruth Armstrong
Charcot-Marie-Tooth disease (CMT) refers to a genetically heterogeneous group of disorders which cause a peripheral motor and sensory neuropathy. The overall prevalence is 1 in 2500 individuals. Mutations in the MFN2 gene are the commonest cause for the axonal (CMT2) type. We describe a Caucasian 5-year old girl affected by CMT2A since the age of 2 years. She presented with unsteady gait, in-turning of the feet and progressive foot deformities. Nerve conduction studies suggested an axonal neuropathy and molecular testing identified a previously reported pathogenic variant c...
January 2017: Neurogenetics
https://www.readbyqxmd.com/read/28031030/outcome-after-protected-full-weightbearing-treatment-in-an-orthopedic-device-in-diabetic-neuropathic-arthropathy-charcot-arthropathy-a-comparison-of-unilaterally-and-bilaterally-affected-patients
#20
Niklas Renner, Stephan Hermann Wirth, Georg Osterhoff, Thomas Böni, Martin Berli
BACKGROUND: Charcot neuropathic arthropathy (CN) is a chronic, progressive, destructive, non-infectious process that most frequently affects the bone architecture of the foot in patients with sensory neuropathy. We evaluated the outcome of protected weightbearing treatment of CN in unilaterally and bilaterally affected patients and secondarily compared outcomes in protected versus unprotected weightbearing treatment. METHODS: Patient records and radiographs from 2002 to 2012 were retrospectively analyzed...
December 29, 2016: BMC Musculoskeletal Disorders
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