Long-term follow-up in diabetic charcot feet with spontaneous onset
Long-term follow-up in diabetic charcot feet with spontaneous onset
复制标题
DOI：
10.2337/diacare.23.6.796
复制
发表时间：
2000-06-01
期刊：
影响因子：
16.2
通讯作者：
Holstein, PE
中科院分区：
文献类型：
--
作者：
Fabrin, J;Larsen, K;Holstein, PE
目的 - 评估糖尿病足自发发作夏科分解后的长期结果。 研究设计和方法 - 本研究是回顾性的。共有 115 名患者（140 英尺），其中 107 名患有急性畸形，8 名患有慢性夏科畸形，随访时间中位数为 48 个月（范围 6-114）。急性病例的常规治疗是使用拐杖进行减重，并使用治疗鞋保护足部，直到皮肤温度恢复正常，然后增加负重并使用定制鞋或改良传统鞋。 结果 - 在所调查的糖尿病人群中，夏科氏畸形的发生率为 0.3%/年。左右大厅的病人都在积极的工作着。 5 名（4%）患者出现严重并发症，需要手术干预：3 名受试者（1 名双侧）因不稳定的踝关节排列不良而接受关节融合术，2 名受试者因不稳定的踝关节和压疮而接受大截肢。 43% 的受试者出现轻微并发症：41 名患者 (36%) 出现新的夏科氏病发作和/或 43 名患者 (37%) 出现足部溃疡，其中 11 名患者需要进行小手术。除 2 名患者外，所有患者均已痊愈：1 名患者在夏科骨折愈合前死亡，1 名患者死于未愈合的溃疡。没有患者丧失独立行走的能力。 结论 - 仅 4% 的重大外科手术与踝关节夏科畸形患者特别相关。大约一半的患者出现轻微并发症。患有夏科足的糖尿病患者需要终生足部护理。
OBJECTIVE - To assess the long-term results after Charcot breakdown with spontaneous onset in diabetic feet.RESEARCH DESIGN AND METHODS - This study was retrospective. A total of 115 patients (140 feet), 107 with acute deformity and 8 with chronic Charcot deformity were followed for a median of 48 months (range 6-114). The routine treatment for acute cases was a weight-off regimen with crutches and foot protection with therapeutic shoes until skin temperature had normalized followed by increased weightbearing and the use of bespoke shoes or modification of conventional shoes.RESULTS - The incidence of Charcot deformity was 0.3%/year in the diabetic population investigated. About hall of the patients were active in their jobs. Major complications were encountered in 5 (4%) of the patients that required surgical intervention: arthrodesis for unstable malaligned ankles in 3 subjects (1 bilaterally) and major amputation in 2 subjects for unstable ankle and pressure sores. Minor complications were recorded in 43% of subjects: new attacks of Charcot breakdown in 41 patients (36%) and/or foot ulceration in 43 patients (37%) that required minor surgical procedures for 11 patients. All healed except in 2 patients: 1 patient died before the Charcot fractures had healed, and 1 patient died with an unhealed ulcer. No patient lost the ability to walk independently.CONCLUSIONS- Major surgical procedures in only 4% were particularly related to patients with Charcot deformities in the ankle. Minor complications were recorded in about half of the patients. Lifelong foot care is required for diabetic patients with Charcot feet.