Onyenemezu Ikenna, Capitle Eugenio
Department of Medicine.
Department of Medicine; Allergy/Immunology Rheumatology Division, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
Open Access Rheumatol. 2014 Jan 10;6:1-6. doi: 10.2147/OARRR.S53757. eCollection 2014.
Diabetic muscle infarction (DMI) is a spontaneous necrosis of skeletal muscle of unknown etiology. The major risk factor is longstanding uncontrolled diabetes mellitus (DM). Optimal treatment for DMI is not known. The purpose of this study was to analyze the outcome of surgical treatment, physiotherapy, and bed rest in DMI.
We searched Medline from its inception to April 2013. We selected cases that provided sufficient data on recovery duration, recurrences, and non-recurrences. Baseline characteristics, including age, sex, microvascular complications, lesion size estimated on magnetic resonance imaging, type of diabetes, and duration of diabetes were assessed. The primary outcome was mean time to recovery from initial treatment and secondary outcomes were mean time to recurrence and recurrence rate.
Mean time to recovery was 149 (95% confidence interval [CI] 113-186), 71 (95% CI 47-96), and 43 (95% CI 30-57) days for surgery, physiotherapy and bed rest, respectively. These figures were statistically significant only for surgery versus physiotherapy and surgery versus bed rest (<0.01). Mean time to recurrence was 30, 107, and 297 days for surgery, physiotherapy, and bed rest, respectively. The recurrence rate was 57%, 44%, and 24% for surgery, physiotherapy, and bed rest, respectively.
Our results show a similar outcome for physiotherapy as compared with bed rest. It also confirms nonsurgical treatment as a better therapeutic option compared with surgical treatment.
糖尿病性肌肉梗死（DMI）是一种病因不明的骨骼肌自发性坏死。主要危险因素是长期未控制的糖尿病（DM）。DMI的最佳治疗方法尚不清楚。本研究的目的是分析DMI的手术治疗、物理治疗和卧床休息的效果。
我们检索了从Medline建立到2013年4月的文献。我们选择了提供有关恢复持续时间、复发和未复发足够数据的病例。评估了基线特征，包括年龄、性别、微血管并发症、磁共振成像估计的病变大小、糖尿病类型和糖尿病病程。主要结局是从初始治疗恢复的平均时间，次要结局是复发的平均时间和复发率。
手术、物理治疗和卧床休息从初始治疗恢复的平均时间分别为149天（95%置信区间[CI]113 - 186）、71天（95%CI 47 - 96）和43天（95%CI 30 - 57）。这些数字仅在手术与物理治疗以及手术与卧床休息之间具有统计学意义（<0.01）。手术、物理治疗和卧床休息复发的平均时间分别为30天、107天和297天。手术、物理治疗和卧床休息的复发率分别为57%、44%和24%。
我们的结果表明，物理治疗与卧床休息的效果相似。这也证实了与手术治疗相比，非手术治疗是更好的治疗选择。
