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Titre : | Charcot Neuroarthropathy Advances: Understanding Pathogenesis and Medical and Surgical Management (2019) |
Auteurs : | Georgeanne Botek ; Samantha Figas ; Sai Narra |
Type de document : | Article |
Dans : | Clinics in Podiatric Medicine and Surgery (Vol. 36, n° 4, October 2019) |
Article en page(s) : | p. 663-684 |
Note générale : | doi:10.1016/j.cpm.2019.07.002 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Arthropathie nerveuse ; Épidémiologie ; Névralgie ; Pachydermopériostose ; Sclérose latérale amyotrophique (SLA) |
Résumé : |
Charcot neuroarthropathy is a complex syndrome of microfractures, dislocations, and soft-tissue changes affecting predominantly the foot and ankle in the neuropathic extremity, chiefly affecting persons with diabetes mellitus. Making advances toward arriving at an early diagnosis to stop the disease process is most important. Understanding new theories of its epidemiology is practice changing. Avoidance of the deformity that predisposes to skin breakdown, prolonged immobility, and more devastating consequences is the ultimate goal and a possibility while using advanced surgical techniques with external fixation and stronger constructs. Medical advances have shown hope of offering other nonsurgical approaches as well, which would make exceedingly prolonged offloading perhaps not the mainstay of treatment in the future.
The treatment of deformities associated with Charcot neuroarthropathy is evolving from a passive approach to one that recognizes the urgency of early recognition. Avoidance of the cascading events, understanding the etiology, and seeking to reclaim a functional foot should be the primary goals of the treating clinician. Understanding the pathogenesis is complex and the treatment is among the most difficult in foot surgery because the intraoperative, perioperative, and postsurgical treatment is demanding, time consuming, and fraught with challenges in the sick patient who is at increased risk of amputation and premature mortality. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0891842219300497 |