Publication Type:

Journal Article

Authors:

Varma, A.K.

Source:

Journal of Foot and Ankle Surgery, Volume 52, Number 6, p.740-749 (2013)

URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84886298919&partnerID=40&md5=324ccf635fe17c40ede917bf62cfed29

Keywords:

alendronic acid, ankle, arthrodesis, arthroplasty, bisphosphonic acid derivative, bone destruction, bone scintiscanning, calcitonin, calcitonin gene related peptide, carboxy terminal telopeptide, cast application, clinical feature, computer assisted tomography, diabetes mellitus, diabetic neuropathy, diagnostic accuracy, disease classification, drug effect, drug safety, early diagnosis, endothelial nitric oxide synthase, foot, foot radiography, human, hydroxyproline, inflammation, interleukin 1, interleukin 6, interleukin 8, joint destruction, neuropathic joint disease, nuclear magnetic resonance imaging, osteoblast, osteoclast, osteoclast differentiation factor, osteoprotegerin, osteosynthesis, pamidronic acid, pathophysiology, placebo, review, sensitivity and specificity, single drug dose, somatomedin C, tumor necrosis factor alpha, ultrasound therapy, walker, zoledronic acid

Abstract:

Charcot neuroarthropathy is a limb-threatening, destructive process that occurs in patients with neuropathy associated with medical diseases such as diabetes mellitus. Clinicians' treating diabetic patients should be vigilant in recognizing the early signs of acute Charcot neuroarthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction, which, if untreated, can lead to morbidity and high-level amputation. A high degree of suspicion is necessary. Once the early signs have been detected, prompt immobilization and offloading are important. Treatment should be determined on an individual basis, and it must be determined whether a patient can be treated conservatively or will require surgical intervention when entering the chronic phase. If diagnosed early, medical and conservative measures only will be required. Surgery is indicated for patients with severeor unstable deformities that, if untreated, will result in major amputations. A team approach that includes a foot and ankle surgeon, a diabetologist, a physiotherapist, a medical social councilor, and, most importantly, the patient and immediate family members is vital for successful management of this serious condition. © 2013 American College of Foot and Ankle Surgeons.

Notes:

cited By (since 1996)0

Cite this Research Publication

A. K. Varma, “Charcot Neuroarthropathy of the Foot and Ankle: A Review”, Journal of Foot and Ankle Surgery, vol. 52, pp. 740-749, 2013.