Robinson Christopher, Major Matthew J, Kuffel Charles, Hines Kevin, Cole Pamela
Jesse Brown VA Medical Center, Northwestern University, Chicago, IL, USA
Jesse Brown VA Medical Center, Northwestern University, Chicago, IL, USA.
Prosthet Orthot Int. 2015 Feb;39(1):73-81. doi: 10.1177/0309364614545422.
Clinical management of the patient with neuropathic foot is becoming commonplace in orthotic clinics worldwide. The presentations that can result from neuropathic foot are diverse, requiring clinicians to understand the pathomechanics of ulceration, infection, and Charcot joint arthropathy to provide effective interventions.
The purpose of this clinical perspective is to provide a review of the literature regarding clinical concepts associated with orthotic management of neuropathic foot.
Literature review and clinical case study.
Relevant literature were reviewed and summarized, and a clinical case study synthesizing reviewed concepts was presented.
Given the multifactorial nature of the neuropathic foot, treatments must be multifaceted and patient-specific to effectively address the underlying disease processes. While systemic issues such as peripheral arterial disease are treated by physicians, local issues such as foot deformity are managed by orthotists. Orthotic interventions commonly include custom footwear to reduce the risk of ulceration through creation of a protective environment or targeted plantar offloading. Patient and caregiver education to encourage management compliance is equally as important to ensure successful treatment.
Patients with neuropathic foot benefit from an interdisciplinary care approach which engages physicians, wound care practitioners, and orthotists to treat and manage systemic and local problems. Addressing this pathology through interdisciplinary care may positively affect the patient's health status while lowering associated healthcare costs through improved treatment efficacy.
The commonality of neuropathic foot and associated complications including ulceration, infection, and Charcot joint arthropathy requires that the patient care team have a fundamental understanding of these pathologies and common treatment modalities. We review orthotic treatment modalities to assist clinicians with the management of patients with neuropathic foot.
在全球范围内的矫形诊所中，对神经性足部患者的临床管理正变得越来越普遍。神经性足部可能导致的表现多种多样，这就要求临床医生了解溃疡、感染和夏科氏关节病的病理力学，以便提供有效的干预措施。
本临床观点的目的是对与神经性足部矫形管理相关的临床概念的文献进行综述。
文献综述和临床案例研究。
对相关文献进行综述和总结，并呈现一个综合所综述概念的临床案例研究。
鉴于神经性足部的多因素性质，治疗必须是多方面的且针对患者个体，以有效解决潜在的疾病过程。虽然诸如外周动脉疾病等全身性问题由医生治疗，但诸如足部畸形等局部问题则由矫形师处理。矫形干预通常包括定制鞋具，通过创造一个保护环境或有针对性地减轻足底压力来降低溃疡风险。对患者和护理人员进行教育以鼓励他们遵守治疗方案，对于确保治疗成功同样重要。
神经性足部患者受益于一种跨学科的护理方法，该方法让医生、伤口护理从业者和矫形师共同参与，以治疗和管理全身性和局部性问题。通过跨学科护理来解决这种病理状况，可能会对患者的健康状况产生积极影响，同时通过提高治疗效果降低相关的医疗成本。
神经性足部及其相关并发症（包括溃疡、感染和夏科氏关节病）的普遍性要求患者护理团队对这些病理状况和常见治疗方式有基本的了解。我们综述了矫形治疗方式，以协助临床医生管理神经性足部患者。
