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Charcot osteo

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https://www.readbyqxmd.com/read/27888790/complication-assessment-and-prevention-strategies-using-midfoot-fusion-bolt-for-medial-column-stabilization-in-charcot-s-osteoarthropathy
#1
Alexander T Mehlhorn, Markus Walther, Niklas Iblher, Norbert P Südkamp, Hagen Schmal
In Charcot's osteoarthropathy stabilization of the medial column of the foot was introduced in order to establish a stable foot and reduce the risk for amputation. This study was performed to analyze postoperative complications, define risk factors for those and develop strategies for prevention. Since bolt dislocation takes place frequently, it was aimed to predict an appropriate time point for bolt removal under the condition that osseous healing has occurred. Fourteen consecutive patients with neuroosteoarthropathy of the foot and arch collapse were treated with open reduction and stabilization using midfoot fusion bolt and lateral lag screws...
November 4, 2016: Foot
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#2
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865318/medical-imaging-in-differentiating-the-diabetic-charcot-foot-from-osteomyelitis
#3
REVIEW
Daniel J Short, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) poses a great challenge to diagnose in the early stages and when plain radiographs do not depict any initial signs of osseous fragmentation or dislocation in a setting of a high clinical index of suspicion. Medical imaging, including magnetic resonance imaging, computed tomography, and advanced bone scintigraphy, has its own unique clinical indications when treating the DCN with or without concomitant osteomyelitis. This article reviews different clinical case scenarios for choosing the most accurate medical imaging in differentiating DCN from osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#4
REVIEW
Claire M Capobianco, Thomas Zgonis
Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865312/an-overview-of-internal-and-external-fixation-methods-for-the-diabetic-charcot-foot-and-ankle
#5
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27810032/corrigendum-to-intramedullary-fixation-in-severe-charcot-osteo-neuroarthropathy-with-foot-deformity-results-in-adequate-correction-without-loss-of-correction-results-from-a-multi-centre-study-foot-ankle-surg-21-2015-269-276
#6
Martinus Richter, Thomas Mittlmeier, Stefan Rammelt, Per-Henrik Agren, Sarah Hahn, Anica Eschler
No abstract text is available yet for this article.
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27749777/utility-of-pet-ct-with-fluorine-18-fluorodeoxyglucose-labeled-autologous-leukocytes-for-diagnosing-diabetic-foot-osteomyelitis-in-patients-with-charcot-s-neuroarthropathy
#7
Ashu Rastogi, Anish Bhattacharya, Mahesh Prakash, Sarika Sharma, Bhagwant R Mittal, Niranjan Khandelwal, Anil Bhansali
OBJECTIVE: Diabetic foot osteomyelitis (DFO) is difficult to diagnose in the presence of Charcot's neuroarthropathy (CN) and bone biopsy is not always possible. We aimed to assess the efficacy of PET/computed tomography using F-fluoride (F-fluoride PET/CT) and fluorine-18-fluorodeoxyglucose-labeled autologous leukocytes (F-FDG-LL PET/CT) in comparison with contrast-enhanced MRI (CEMRI) for the detection of DFO. PATIENTS AND METHODS: Thirty-two patients with chronic CN and foot ulcer suspected of having DFO were prospectively evaluated...
October 4, 2016: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27553085/outcomes-of-osteomyelitis-in-patients-hospitalized-with-diabetic-foot-infections
#8
Dane K Wukich, Kimberlee B Hobizal, Tresa L Sambenedetto, Kristin Kirby, Bedda L Rosario
BACKGROUND: This study was conducted to evaluate the outcomes of patients with diabetic foot osteomyelitis (DFO) compared to diabetic foot soft tissue infections (STIs). METHODS: 229 patients who were hospitalized with foot infections were retrospectively reviewed, identifying 155 patients with DFO and 74 patients with STI. Primary outcomes evaluated were the rates of amputations and length of hospital stay. DFO was confirmed by the presence of positive bone culture and/or histopathology...
December 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27058729/spinal-neuroarthropathy-pathophysiology-clinical-and-imaging-features-and-differential-diagnosis
#9
Luke N Ledbetter, Karen L Salzman, R Kent Sanders, Lubdha M Shah
Spinal neuroarthropathy (SNA), or Charcot spine, is a progressive destructive arthropathy occurring after loss of neuroprotective sensation and proprioceptive reflexes. Clinical diagnosis is difficult because of the variable length to presentation after initial neurologic damage and the limited symptoms given preexisting neurologic deficits. SNA is also a diagnostic challenge because its imaging features are similar to those of spinal conditions such as discitis-osteomyelitis, osseous tuberculosis, hemodialysis-related spondyloarthropathy, and pseudarthrosis...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/26961279/extension-and-grading-of-osteomyelitis-are-not-related-to-limb-salvage-in-charcot-neuropathic-osteoarthropathy-a-cohort-prospective-study
#10
Luca Dalla Paola, Anna Carone, Marco Baglioni, Giulio Boscarino, Lucian Vasilache
AIMS: Charcot neuropathic osteoarthropathy (CN) represents a complication for diabetic patients which involves a progressive alteration of the osteoarticular apparatus with high risk of amputation. The aim of the study was to assess whether the localization of CN and the extent or grading of the osteomyelitis have an influence on the rate of limb salvage and the time to recovery. METHODS: We treated a diabetic population affected by CN complicated by ulceration and widespread osteomyelitic involvement...
May 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/26850144/the-impact-of-comorbidities-on-inpatient-charcot-neuroarthropathy-cost-and-utilization
#11
Jonathan M Labovitz, David W Shofler, Kevin K Ragothaman
AIMS: The purpose of this study was to portray the impact of comorbidities on inpatient cost and utilization in Charcot neuroarthropathy (CN) patients. METHODS: Two cohorts, CN and diabetic peripheral neuropathy (DPN), were identified by ICD-9 codes in the California Office for Statewide Health Planning and Development 2009-2012 public patient discharge files. DPN and CN costs and length of stay (LOS) were compared adjusting for the number of chronic conditions...
May 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/26802944/current-concepts-of-charcot-foot-in-diabetic-patients
#12
REVIEW
Javier La Fontaine, Lawrence Lavery, Edward Jude
The Charcot foot is an uncommon complication of neuropathy in diabetes. It is a disabling and devastating condition. The etiology of the Charcot foot is unknown, but it is characterized by acute inflammation with collapse of the foot and/or the ankle. Although the cause of this potentially debilitating condition is not known, it is generally accepted that the components of neuropathy that lead to foot complications must exist. When it is not detected early, a severe deformity will result in a secondary ulceration, infection, and amputation...
March 2016: Foot
https://www.readbyqxmd.com/read/26643184/from-bone-to-heart-a-case-of-mrsa-osteomyelitis-with-haematogenous-spread-to-the-pericardium
#13
Parinita A Dherange, Sarah Patel, Evbu Enakpene, Prakash Suryanarayana
We report a case of a 55-year-old woman with a history of type 2 diabetes mellitus, Charcot arthropathy and end-stage renal disease, who presented with a syncopal episode after undergoing haemodialysis. She had a history of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia from an unknown source 3 months earlier, which was treated with an 8-week course of intravenous antibiotics. At the time of presentation to the emergency room, she was found to be in refractory shock. Bedside echocardiogram was performed, which showed moderate pericardial effusion...
December 7, 2015: BMJ Case Reports
https://www.readbyqxmd.com/read/26564730/intramedullary-fixation-in-severe-charcot-osteo-neuroarthropathy-with-foot-deformity-results-in-adequate-correction-without-loss-of-correction-results-from-a-multi-centre-study
#14
MULTICENTER STUDY
Martinus Richter, Thomas Mittlmeier, Stefan Rammelt, Per-Henrik Agren, Sarah Hahn, Anica Eschler
BACKGROUND: Charcot osteo-neuroarthropathy (CN) of the foot can induce severe instability and deformity. Results of a consecutive clinical multi-centre study with Midfoot Fusion Bolt (MFB, Synthes GmbH, Oberdorf, Switzerland) are reported. METHODS: All patients (aged 18 years and older) treated between 2009 and 2013 with surgical reconstruction of the midfoot with MFB for CN were included. Demographics, pre-surgical health status, details of foot pathology, details of surgery, postoperative treatment, treatment failure, and adverse events were registered...
December 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/26452590/surgical-management-of-charcot-neuroarthropathy-of-the-ankle-and-hindfoot-in-patients-with-diabetes
#15
Dane K Wukich, Katherine M Raspovic, Kimberlee B Hobizal, David Sadoskas
BACKGROUND: Charcot neuroarthropathy (CN) of the ankle and hindfoot (Sanders/Frykberg Type IV) is challenging to treat surgically or nonsurgically. The deformities associated with ankle/hindfoot CN are often multiplanar, resulting in sagittal, frontal and rotational malalignment. In addition, shortening of the limb often occurs from collapse of the distal tibia, talus and calcaneus. These deformities also result in significant alterations in the biomechanics of the foot. For example, a varus ankle/hindfoot results in increased lateral column plantar pressure of the foot, predisposing the patient to lateral foot ulceration...
January 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/26451965/acute-charcot-neuro-osteoarthropathy
#16
N L Petrova, M E Edmonds
Charcot neuro-osteoarthropathy (CN) is one of the most challenging foot complications in diabetes. Common predisposing and precipitating factors include neuropathy and increased mechanical forces, fracture and bone resorption, trauma and inflammation. In the last 15 years, considerable progress has been made in the early recognition of the acute Charcot foot when the X ray is still negative (stage 0 or incipient Charcot foot). Recent advances in imaging modalities have enabled the detection of initial signs of inflammation and underlying bone damage before overt bone and joint destruction has occurred...
January 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/26276212/lower-extremity-amputation-and-mortality-rates-in-the-reconstructed-diabetic-charcot-foot-and-ankle-with-external-fixation-data-analysis-of-116-patients
#17
Crystal L Ramanujam, David Han, Thomas Zgonis
UNLABELLED: The aim of this study was to determine the lower extremity amputation and mortality rates of a group of patients who underwent reconstructive surgery using circular external fixation for treatment of diabetic Charcot neuroarthropathy (CN) of the foot and/or ankle. Existing studies regarding lower extremity amputation or mortality rates for diabetic CN of the foot and/or ankle have been performed on mostly conservatively treated patients. The objective of the statistical analysis in this studied population was to understand the difference in overall amputation and mortality rates between the 2 main groups: one with foot and/or ankle ulceration (group 1), and the other without ulceration or osteomyelitis (group 2, control group)...
April 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/26258980/-orthopedic-surgical-management-of-the-diabetic-foot
#18
Tomáš Kučera, Jaromír Šrot, Josef Roubal, Pavel Šponer
The basic prerequisite for the successful treatment of the diabetic foot is a multidisciplinary approach. Ideally, the diagnosis and treatment is managed by a podiatrist, who is also responsible for a cost-effective and well-managed setting. General concern of diabetics is the fear of losing a limb. On the basis of multidisciplinary approach is pos-sible to prevent major amputations in many cases, or in case of them to ensure the prosthetic and rehabilitation care. New possibilities of revascularization and cooperation with antibiotic centers increase the success of surgical treatment of diabetic foot syndrome...
June 2015: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/26223236/pin-tract-infection-following-correction-of-charcot-foot-with-static-circular-fixation
#19
Elissa S Finkler, Christopher Kasia, Ellen Kroin, Victoria Davidson-Bell, Adam P Schiff, Michael S Pinzur
BACKGROUND: The traditional nonsurgical accommodative treatment for diabetes-associated Charcot foot arthropathy has been unsuccessful in improving the quality of life in affected individuals. This has led to the growing interest in surgical correction of the acquired deformity with either "super construct" internal fixation implants or fine-wire static circular external fixation. The use of static circular external fixation without implants has been demonstrated to achieve high rates of deformity correction with low complication rates...
November 2015: Foot & Ankle International
https://www.readbyqxmd.com/read/25862127/-tibiotalocalcaneal-corrective-arthrodesis-in-charcot-arthropathy-of-the-ankle-with-a-retrograde-nail
#20
J von Recum
BACKGROUND: Involvement of the ankle joint in Charcot osteoarthropathy is most often associated with severe instability and fracture or collapse of the talus. Caused by malalignment, ulcerations over both malleoli are associated with increased risk of major amputation. OBJECTIVE: The goal of the operation is to realign the hind foot, gain a stable osteosynthesis, and prevent major amputation. INDICATIONS: Charcot osteoarthropathy of the ankle joint with instability, with or without soft tissue involvement, failure of the primary arthrodesis of the ankle or subtalar joint...
April 2015: Operative Orthopädie und Traumatologie
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