Frykberg R G, Mendeszoon E
Des Moines University, College of Podiatric Medicine, 3200 Grand Ave, Des Moines, IA 50312, USA.
Diabetes Metab Res Rev. 2000 Sep-Oct;16 Suppl 1:S59-65. doi: 10.1002/1520-7560(200009/10)16:1+<::aid-dmrr134>3.0.co;2-n.
The diabetic Charcot foot is a major limb-threatening complication of long-term diabetes mellitus and neuropathy. Although first described over 100 years ago, we are still lacking definitive studies regarding its prevalence in this population, precise etiology, or most effective treatments. Trauma in the presence of peripheral sensory neuropathy and abundant arterial perfusion seem to be the primary causal factors leading to this severe foot deformity. Misdiagnosis or delayed diagnosis of osteoarthropathy allows the destructive phase of this disorder to continue with resultant further destruction of the foot architecture. The authors discuss the natural history of this entity as well as potential treatment options and recommendations. Through a better understanding of the underlying pathogenesis, Charcot arthropathy can be more effectively managed and thereby limit the development of severe deformity, ulceration, infection and limb loss.
糖尿病夏科氏足是长期糖尿病和神经病变导致的一种严重威胁肢体的并发症。尽管在100多年前就有相关描述，但我们仍缺乏关于其在该人群中的患病率、确切病因或最有效治疗方法的确切研究。周围感觉神经病变和丰富的动脉灌注情况下的创伤似乎是导致这种严重足部畸形的主要因果因素。骨关节炎的误诊或延迟诊断会使该疾病的破坏阶段持续，进而导致足部结构进一步破坏。作者讨论了该病症的自然病程以及潜在的治疗选择和建议。通过更好地理解潜在的发病机制，可以更有效地管理夏科氏关节病，从而限制严重畸形、溃疡、感染和肢体缺失的发展。
