tailieunhanh - báo cáo hóa học:" Charcot foot reconstruction with combined internal and external fixation: case report"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : Charcot foot reconstruction with combined internal and external fixation: case report | Capobianco et al. Journal of Orthopaedic Surgery and Research 2010 5 7 http content 5 1 7 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH CASE REPORT Open Access Charcot foot reconstruction with combined internal and external fixation case report Claire M Capobianco Crystal L Ramanujam Thomas Zgonis Abstract Charcot neuroarthropathy is a destructive and often-limb threatening process that can affect patients with peripheral neuropathy of any etiology. Early recognition and appropriate management is crucial to prevention of catastrophic outcomes. Delayed diagnosis and subsequent pedal collapse often preclude successful conservative management of these deformities and necessitate surgical intervention for limb salvage. We review the current literature on surgical reconstruction of Charcot neuroarthropathy and present a case report of foot reconstruction with combined internal and external fixation methods. Background Charcot neuroarthropathy CN was originally described in 1868 1 as a rare affliction of patients with leprosy and alcoholism that resulted in fragmentation collapse and subsequent deformity of the pedal joints in the neuropathic lower extremity. The demographics of patients with CN today reflect the exponential rise in the prevalence of diabetes mellitus over the last twenty years. Charcot neuroarthropathy develops in approximately of patients with diabetic peripheral neuropathy and has significant long term prognostic implications 2 3 . Charcot collapse of pedal architecture predictably progresses to plantar deformity ulceration and ultimately if not addressed infection and amputation. Ten to fifteen percent of patients with diabetes mellitus will undergo lower extremity amputation in their lifetime 4 with CN deformity a clear amputation risk factor. Although the pathophysiology of the disease remains unknown two principal theories have been proposed. The neurotraumatic theory postulates that repetitive microtrauma in the .