Weiner Richard D, Hlad Lee M, McKenna Danielle R
Residency Director, Podiatric Medicine and Surgery, Grant Medical Center, Columbus, OH, USA.
Diabet Foot Ankle. 2011;2. doi: 10.3402/dfa.v2i0.6417. Epub 2011 May 11.
Foot and ankle surgeons are frequently challenged by the devastating systemic consequences of diabetes mellitus manifested through neuropathy, integumentary and joint breakdown, delayed healing, decreased ability to fight infection, and fragile tendon/ligaments. Diabetic neuropathic pedal ulcerations lead to amputations at an alarming rate and also carry a high mortality rate. This article will discuss causes of diabetic pedal ulcerations that persist or recur after tendo-Achilles lengthening and will highlight areas that need to be addressed by the practitioner such as infection, vascular and nutritional status, glucose control, off-loading, biomechanics, and patient compliance.
足踝外科医生经常面临糖尿病带来的严重全身性后果的挑战，这些后果表现为神经病变、皮肤和关节破损、愈合延迟、抗感染能力下降以及肌腱/韧带脆弱。糖尿病性神经病变导致的足部溃疡以惊人的速度导致截肢，且死亡率也很高。本文将讨论跟腱延长术后持续或复发的糖尿病足部溃疡的原因，并强调从业者需要关注的领域，如感染、血管和营养状况、血糖控制、减压、生物力学以及患者的依从性。
