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https://www.readbyqxmd.com/read/27923212/comparison-of-diabetic-charcot-patients-with-and-without-foot-wounds
#1
Dane K Wukich, David Sadoskas, Nicholas J Vaudreuil, Mitchell Fourman
BACKGROUND: The primary aim of this study was to evaluate the outcomes of a series of patients with Charcot neuroarthropathy (CN) who were evaluated in a tertiary care setting. We hypothesized that those patients with CN who presented with a Charcot-related foot wound would have lower rates of successful limb salvage than patients who presented without a wound. METHODS: Two hundred forty-five patients (280 feet) were identified with diabetic CN during the time period from January 1, 2005, to June 1, 2015...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27888790/complication-assessment-and-prevention-strategies-using-midfoot-fusion-bolt-for-medial-column-stabilization-in-charcot-s-osteoarthropathy
#2
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/27865320/the-diabetic-charcot-foot-and-ankle-a-multidisciplinary-team-approach
#3
EDITORIAL
Thomas Zgonis
No abstract text is available yet for this article.
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#4
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
#5
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/27865317/revisional-surgery-of-the-diabetic-charcot-foot-and-ankle
#6
REVIEW
Patrick R Burns, Spencer J Monaco
Charcot neuroarthropathy (CN) is a difficult problem for the foot and ankle surgeon. If surgery is required, little is known or available regarding the best methods and timing. When the initial attempt of reconstruction fails, revision of CN is even more demanding. One must take in to account all aspects, including nutrition, vascular status, infection control, short- and long-term blood glucose management, as well as other factors requiring laboratory monitoring and consult services. Once optimized, the biomechanics of the deformity can be addressed and decisions can be made on fixation devices...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#7
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/27865315/surgical-treatment-options-for-the-diabetic-charcot-hindfoot-and-ankle-deformity
#8
REVIEW
Tahir Ögüt, Necip Selcuk Yontar
Charcot neuroarthropathy is associated with progressive, noninfectious, osteolysis-induced bone and joint destruction. When the ankle and/or hindfoot is affected by the destruction process, management is further complicated with collapse and destruction of the talar body, which increases instability around the ankle. In this patient population, arthrodesis is the most commonly used surgical procedure. Internal fixation, external fixation, or a combination of both can be used for the treatment. Decision making between them should be individualized according to the patient characteristics...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#9
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865313/surgical-equinus-correction-for-the-diabetic-charcot-foot-what-the-evidence-reveals
#10
REVIEW
Claire M Capobianco
Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies...
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
#11
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/27865311/conservative-and-pharmacologic-treatments-for-the-diabetic-charcot-foot
#12
REVIEW
Nina L Petrova, Michael E Edmonds
Charcot neuroarthropathy is a disabling complication of diabetic neuropathy. Prolonged immobilization in a total contact cast (TCC) is among the main treatments. Education of health care professionals in the application of TCC together with well-conducted clinical trials are required to overcome its frequent underuse. There are no established pharmacologic therapies to treat this condition; however, there is an overwhelming need for a new therapeutic approach. Novel targeted drug delivery systems are required to prevent the pathologic bone and joint destruction of the Charcot neuroarthropathy and this may lead to an improved outcome in diabetic patients with this condition...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865310/the-diabetic-charcot-foot-from-1936-to-2016-eighty-years-later-and-still-growing
#13
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Knowledge of diabetic Charcot neuroarthropathy (DCN) has grown tremendously since this condition was first described in 1936 by William Riely Jordan. Despite advancements in diagnostic approaches and treatment options making DCN limb salvage a more viable option, ongoing and additional research is needed to determine the definitive pathogenesis, which may aid in prevention of the condition. This article chronicles the main developments for the study and management of DCN since 1936 and recommends using the term diabetic Charcot-Jordan foot when specifically managing foot and ankle neuroarthropathy joints in patients with diabetic neuropathy...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27863489/the-effect-of-cumulative-glycemic-burden-on-the-incidence-of-diabetic-foot-disease
#14
Robert G Dekker, Charles Qin, Bryant S Ho, Anish R Kadakia
BACKGROUND: Glycemic control is a known modifiable risk factor for diabetic foot disease. Prior attempts to define its relationship with diabetic foot ulcer and Charcot arthropathy fail to account for variability in control and duration of diabetic disease. We developed a novel metric to reflect aggregate disease exposure in a diabetic, termed cumulative glycemic burden. We hypothesized that it would be positively associated with both diabetic foot ulcer and radiographically diagnosed Charcot arthropathy...
November 18, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27811058/vanishing-bone-disease-a-manifestation-of-diabetic-charcot-s-neuropathic-osteoarthropathy
#15
Ashu Rastogi, Anil Bhansali
No abstract text is available yet for this article.
November 3, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27807290/examining-the-potential-use-of-a-novel-radiographic-scoring-system-for-determining-surgical-intervention-in-diabetic-charcot-arthropathy
#16
Rahul Bijlani, Laurie M Lomasney, Michael Pinzur, Katherine Dux
: Introduction Although Eichenholtz and the Schon systems are commonly used to evaluate foot Charcot arthropathy on radiographs, a novel system with expanded characterization may have added benefit. Methods Patients with Charcot arthropathy and foot radiographs were grouped in nonsurgical group 1 (imaging sets at minimum 2-year interval) and surgical group 2 (imaging preceding fusion and/or amputation). Radiographs were scored with Eichenholtz and Schon systems, and a novel scoring system (summation of 0-3 rank for bone density, distention/swelling, debris, disorganization, and dislocation/subluxation)...
November 1, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27766013/clinical-and-roentgenological-profiles-of-five-patterns-of-charcot-foot-in-diabetes-a-case-series
#17
Partha P Chakraborty, Shinjan Patra, Sugata N Biswas, Gouranga Santra, Satinath Mukhopadhyay, Subhankar Chowdhury
No abstract text is available yet for this article.
October 2016: Clinical Diabetes: a Publication of the American Diabetes Association
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
#18
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/27714504/diabetic-charcot-neuroarthropathy-prevalence-demographics-and-outcome-in-a-regional-referral-centre
#19
A O'Loughlin, E Kellegher, C McCusker, R Canavan
BACKGROUND: Diabetic Charcot neuroarthropathy (DCN) is a devastating complication for people with diabetes mellitus. The failure to diagnose DCN and institute treatment in the acute phase leads to permanent deformity and significant morbidity. There is a paucity of data on the prevalence and characteristics of patients who have developed this complication of diabetes. AIMS: To determine the prevalence, clinical characteristics and outcomes of patients with DCN from 2006 to 2012...
October 6, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27702429/conventional-deep-pressure-algometry-is-not-suitable-for-clinical-assessment-of-nociception-in-painless-diabetic-neuropathy
#20
Ernst A Chantelau
BACKGROUND: In diabetic persons with painless neuropathic foot ulceration, foot skin was found to be insensate to noxious pinprick stimulation (stimulation area less than 0.05 mm(2)), while compression of deep subcutaneous foot tissues by Algometer II(®) (stimulation area 1 cm(2)) could evoke a deep dull aching. To elucidate this discrepancy, the Algometer II stimulation technique was critically reviewed by varying probe sizes and anatomical sites in the same study population 3 years later...
2016: Diabetic Foot & Ankle
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