Triggering mechanisms of neuroarthropathy following conservative surgery for osteomyelitis

Diabetic Medicine : a Journal of the British Diabetic Association
J Aragón-SánchezM J Hernández-Herrero

Abstract

The purpose of this study was to raise awareness and stimulate discussion of the possible triggering factors of Charcot neuroarthropathy by presenting the case of one patient who had both undergone surgery and was suffering from osteomyelitis. We have extracted one case from our data set for a patient who underwent conservative surgery for osteomyelitis and subsequently developed acute Charcot in the midfoot. We present the clinical findings, photographs and X-ray studies. Preoperative X-ray showed irregular severe bone destruction in the fourth metatarsal head and a fracture of the fourth metatarsal bone. No signs of midfoot Charcot neuroarthropathy were found in this preoperative X-ray. The third and fourth metatarsal bones were both removed and the surgical wound was left open to heal by second intention. Histopathological study confirmed osteomyelitis in the bone sample. Twenty-five days after surgery, the surgical wound showed no signs of infection and healing progressed in a satisfactory way. However, the foot was swollen, erythematous and warm. Skin temperature was two degrees higher than the contralateral foot. X-ray was taken and acute neuroarthropathy of the tarso-metatarsal joints was diagnosed. Charcot neuroarthropa...Continue Reading

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Dec 3, 2008·Diabetic Medicine : a Journal of the British Diabetic Association·W J JeffcoateUNKNOWN International Working Group on the Diabetic Foot
Dec 3, 2008·Diabetic Medicine : a Journal of the British Diabetic Association·A NdipA J Boulton

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Citations

Aug 7, 2013·Diabetic Foot & Ankle·Gökhan KaynakTahir Oğüt
Jan 10, 2012·Journal of Tissue Viability·Javier Aragón-SánchezMaría J Hernández-Herrero
Apr 18, 2013·Diabetic Medicine : a Journal of the British Diabetic Association·J Aragón-SánchezM J Hernández-Herrero
Apr 15, 2016·Singapore Medical Journal·Aishah Ahmad FauziLydia Abdul Latif
Jan 24, 2015·Prosthetics and Orthotics International·Osaretin B Idusuyi
Sep 27, 2013·Diabetic Foot & Ankle·Crystal L RamanujamThomas Zgonis
Sep 23, 2016·Journal of Diabetes Research·Tomas KuceraPavel Sponer
Oct 4, 2017·Journal of Orthopaedic Surgery and Research·Hong-Mou ZhaoDing-Jun Hao

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