Ostectomy for diabetic neuroarthropathy involving the midfoot

Catanzariti, Alan R.; Mendicino, Robert W.; Haverstock, Brent D.

doi:10.1016/s1067-2516(00)80045-9

Cited by 96 publications

(49 citation statements)

References 8 publications

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“…Carefully selected surgical procedures such as arthroplasties of affected joints with limited joint mobility in the forefoot may have value in promoting wound healing [51]. Furthermore, exostectomy procedures have been reported to be relatively reliable methods of treatment for rigid, prominent deformities secondary to Charcot's neuro-osteoarthropathy [58,59].…”

Section: Surgical Offloadingmentioning

confidence: 99%

The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review

Bus

Valk

Deursen

et al. 2008

Diabetes Metab. Res. Rev.

217

182

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SummaryBackground Footwear and offloading techniques are commonly used in clinical practice for the prevention and treatment of foot ulcers in diabetes, but the evidence base to support this use is not well known. The goal of this review was to systematically assess the literature and to determine the available evidence on the use of footwear and offloading interventions for ulcer prevention, ulcer treatment, and plantar pressure reduction in the diabetic foot.

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Section: Surgical Offloadingmentioning

confidence: 99%

The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review

Bus

Valk

Deursen

et al. 2008

Diabetes Metab. Res. Rev.

217

182

View full text Add to dashboard Cite

show abstract

“…Surgical correction of deformities has been used with variable results in chronic CN. Techniques such as arthrodesis [82,116], exostectomies [117], reconstruction [118,119,120] and Achilles tendon lengthening [121] have been carried out. In one of the largest series, 221 cases of CN were reported, whereby surgical arthrodesis was indicated in two-thirds of the hind foot in CN patients, whereas only one-third of the mid-tarsal joint CN required surgery [123].…”

Section: Managementmentioning

confidence: 99%

“…We do not advocate routine surgery in the diabetic foot to correct deformities. However, in appropriate cases a simple procedure, such as excision of abnormally weight-bearing bone [117,125] can allow the use of appropriate footwear and reduce the chance of further foot ulceration.…”

Section: Managementmentioning

confidence: 99%

Charcot neuroarthropathy in diabetes mellitus

et al. 2002

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Charcot neuroarthropathy has been recognised for over 130 years and yet it remains a major cause of morbidity for patients with diabetes mellitus and a continuing challenge for physicians. It is rare but it seems to be increasing in prevalence and this provides hope that with larger studies it will soon be possible to clarify the natural history and optimal treatment regimens. The underlying cause is thought to be trauma in a neuropathic foot that leads to a complex series of pathological processes culminating in bone and joint destruction and subsequent deformity. The acute reaction is often misdiagnosed and many patients present late with established deformity. Even when the diagnosis is considered at an early stage there are no definitive criteria or tests to confirm charcot neuroarthropathy and a high index of suspicion is necessary in any diabetic patient with a swollen warm foot in the presence of somatic or autonomic neuropathy. Treatment has traditionally involved the use of various methods to avoid weight bearing but recent work has begun to suggest that bisphosphonates might be able to arrest the acute process. In the long term, treatment involves a multidisciplinary approach aimed at providing appropriate footwear to reduce plantar pressures and avoid foot ulceration; in some circumstances this involves surgical correction of deformities before adequate footwear can be supplied. Further studies of the emerging treatments for Charcot neuroarthropathy are needed to provide long-term outcome data on morbidity and deformity.

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“…For patients without instability, such as those in the present study, the most common operative procedure is removal of the bony prominence on the medial or plantar aspect of the foot (14). Such decompressing ostectomy will usually allow the foot to fit into a custom-molded shoe, and the need for additional surgical intervention can be avoided in some cases (15).…”

Section: Discussionmentioning

confidence: 99%