Neuroarthropathy, một, nhanh chóng không đau quá trình phá hoại, trở thành ngày càng phổ biến ĐÃ sống lâu Trong số các bệnh nhân tiểu đường. Nó là đặc điểm ấm áp, khớp sưng lên với sự xuất hiện chụp ảnh phóng xạ hết sức vô tổ chức, mặc dù nào IS Thường thì bệnh nhân đau-miễn phí. | Management of Neuropathic Fractures in the Foot and Ankle Mark S. Myerson MD and William H. B. Edwards MB BS MS FRACS Abstract Neuroarthropathy a rapid painless destructive process has become increasingly prevalent among long-lived diabetic patients. It is characterized by warm swollen joints with a grossly disorganized radiographic appearance in spite of which the patient is often pain-free. Neglect of this condition results in progressive deformity or instability often complicated by ulceration and infection which can ultimately result in loss of independent mobility loss of the affected limb and even death. In most cases a plantigrade stable and functional foot can be achieved with simple nonoperative techniques such as the use of a totalcontact cast or shoe modification. A few patients in whom uncontrolled instability or major osseous prominences cause recurrent ulceration will require reconstructive surgery either exostectomy or osteotomy arthrodesis . Although some patients will have an improvement in function ongoing vigilance is necessary. J Am Acad Orthop Surg 1999 7 8-18 We are accustomed to thinking of foot and ankle fractures in the patient with diabetes as Charcot injuries. Although this terminology does describe a disease process it is now of historic interest only the term neuroarthropathy more correctly describes the rapid onset of painless and severe joint destruction. This disease process was discussed by Charcot in 1868 with reference to a patient with locomotor ataxia and posterior column dysfunction of the spinal cord tabes dorsalis .1 In 1936 Jordon was the first to associate diabetes with Fractures and dislocations are part of the spectrum of this arthropathy which has a varied presentation. The sine qua non of neuroarthropathy is architectural disruption and disorganization of the foot either in the absence of pain or without an appropriate level of In the 19th century syphilis was a common cause of this form of .
