Nonoperative treatment of neuro-osteoarthropathy of the foot: do we need new criteria?
Nonoperative treatment of neuro-osteoarthropathy of the foot: do we need new criteria?
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DOI：
10.1016/j.cpm.2007.03.006
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发表时间：
2007-07-01
影响因子：
0.6
通讯作者：
Poll, Ludger W
中科院分区：
文献类型：
--
作者：
Chantelau, Ernst;Kimmerle, Renate;Poll, Ludger W
对疼痛不敏感的足的神经性骨关节病的最差表现是Charcot足，其具有破坏性的骨关节破坏和不可逆的畸形。新的诊断工具，如MRI，揭示了机械损伤和过度使用是疾病的起源。传统上，只有在X线平片上有明显骨和关节损伤的足部（骨折和脱位损伤）才接受非手术治疗，采用卸载和固定;然而，通过卸载和固定治疗无痛、看似无症状的非骨折损伤（骨挫伤或骨髓水肿）已被证明在预防夏科足方面非常有效。药物治疗是否在预防或治愈骨关节破坏方面发挥作用仍有待证实。
The worst manifestation of neuro-osteoarthropathy of the pain-insensitive foot is the Charcot foot with its devastating osteoarticular destructions and irreversible deformities. New diagnostic tools such as MRI have revealed that mechanical injury and overuse is the origin of the condition. Traditionally, only feet with bone and joint damage apparent on plain radiographs (fracture and dislocation injuries) have undergone nonoperative treatment with off-loading and immobilization; however, treating painless, seemingly asymptomatic nonfracture injuries (bone bruise or bone marrow edema) with off-loading and immobilization has proven highly effective in preventing the Charcot foot. Whether pharmaceutical treatment has a role in terms of prevention or healing of osteoarticular destructions remains to be demonstrated.