University of Pittsburgh Medical Center Comprehensive Foot and Ankle Center, Pittsburgh, PA, USA.
Med Clin North Am. 2013 Sep;97(5):873-82. doi: 10.1016/j.mcna.2013.03.013. Epub 2013 Jul 6.
Many surgical and nonsurgical options exist with the aim of improving quality of life and preventing amputation in patients with CN. A multidisciplinary approach is necessary to achieve the best outcomes in this high-risk group. Modern advanced diagnostic and imaging techniques have improved knowledge regarding the biomechanics, biology, and pathophysiology of CN. Despite these advances, surgical management has lagged behind and is based largely on retrospective case series and expert opinion. Although the surgeons of today are better equipped to manage CN, the optimal timing and specific method of surgical treatment have yet to be defined. Multicenter, prospective studies may be the best way to study this relatively uncommon problem.
许多手术和非手术选择的存在目的是提高生活质量并预防慢性肾病患者的截肢。对于这一高风险群体，需要采取多学科方法以获得最佳效果。现代先进的诊断和成像技术提高了人们对慢性肾病的生物力学、生物学和病理生理学的认识。尽管取得了这些进展，但手术管理仍相对滞后，主要基于回顾性病例系列和专家意见。尽管当今的外科医生更有能力管理慢性肾病，但最佳的手术治疗时机和具体方法尚未确定。多中心前瞻性研究可能是研究这一相对罕见问题的最佳方法。
