[Reconstructive surgery for Charcot foot. Long-term 5-year outcome].

Der Orthopäde
U IllgnerH H Wetz

Abstract

Diabetic neuropathic osteoarthropathy (DNOAP) often leads to progressive malpositioning of the foot with subsequent ulcers and a high risk of amputation. There are very few reliable studies on long-term outcome. This study includes the largest follow- up collective ever carried out. In a retrospective study 205 surgical procedures (195 patients) for complex malpositioning of the foot and/or chronic ulcers using a fixateur externe (188 cases) or Steinmann pins (17 cases) in patients with NOAP were included. The average follow-up time was 21 months. The goal was walking without pain in customized orthopedic shoes and avoiding amputation. No primary amputations were necessary. Patient activity improved by more than 1 level according to the classification for lower limb amputees following the Hofer activity score. The most common minor complication was persistence or recurrence of ulcers in 48 patients. Only 7 new recurrences of NOAP were observed. In 15 patients secondary amputation was necessary. Approximately 50% of the patients could be mobilized with the help of customized orthopedic shoes 18 months after surgery. By using a fixateur externe many amputations could be avoided and patient's activity could be improved. The interd...Continue Reading

References

May 1, 1994·The Journal of Emergency Medicine·M T LynchH N Himel
Jun 1, 1997·Journal of the American Podiatric Medical Association·D G ArmstrongT R Bushman
May 19, 1998·Clinical Orthopaedics and Related Research·L C SchonS B Weinfeld
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Jun 7, 2000·Diabetes Care·J FabrinP E Holstein
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Mar 21, 2003·Der Orthopäde·A EckardtS Schadmand-Fischer
Mar 29, 2008·Der Unfallchirurg·T MittlmeierM Beck

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Citations

Jul 23, 2011·Der Unfallchirurg·S RammeltH Zwipp
Aug 12, 2014·Foot & Ankle International·Jason T BariteauJames W Brodsky
Feb 16, 2013·Foot & Ankle International·Ulrich IllgnerHans Henning Wetz
Sep 3, 2017·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Uazman AlamRayaz A Malik
Nov 18, 2017·BMC Musculoskeletal Disorders·Martin BerliCharlotte Baltin

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