López-Gavito E, Gómez-Fuentes N A, Parra-Téllez P, Lezama-Peniche M, Vázquez-Escamilla J, León-Hernández S R
Servicio de Deformidades Neuromusculares, Tobillo y Pie. Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, CP 14389, Del. Tlalpan, Ciudad de México.
Alta Especialidad en Cirugía del Pie y Tobillo. Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, CP 14389, Del. Tlalpan, Ciudad de México.
Acta Ortop Mex. 2016 Sep-Oct;30(5):223-230.
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living.
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living.
observational, prospective, transversal, descriptive.
patients diagnosed with Charcot neuropathy type 3a of Brodsky. Surgically treated by ankle arthrodesis with an intramedullary blocked nail, from January 2010 to August 2015.
16 patients were analyzed. Preoperative AOFAS score was 35.0 ± 5.2 points. Postoperative follow-up period of 4 years to 7 months. Postoperative AOFAS scale showed an improvement of 40 points (p = 0.0001).
The proposed treatment allows bone stabilization, resulting in a full foot plantar support and decreases the occurrence of chronic ulcers that are difficult to treat, and is an alternative method that avoids lead to amputation.
夏科氏关节病被定义为一种关节退行性、慢性、进行性疾病，影响一个或多个外周关节，是由于足部和踝部关节神经支配中正常感觉（疼痛和本体感觉）丧失而发展形成的，其特征为存在无感染的破坏性骨病变。神经病变与1型和2型糖尿病直接相关。当软组织严重受累、足部关节不稳定、存在慢性或复发性溃疡，或者足部和踝部无法适配正常鞋子且日常生活活动受限，表明需要进行手术。
夏科氏关节病被定义为一种关节退行性、慢性、进行性疾病，影响一个或多个外周关节，是由于足部和踝部关节神经支配中正常感觉（疼痛和本体感觉）丧失而发展形成的，其特征为存在无感染的破坏性骨病变。神经病变与1型和2型糖尿病直接相关。当软组织严重受累、足部关节不稳定、存在慢性或复发性溃疡，或者足部和踝部无法适配正常鞋子且日常生活活动受限，表明需要进行手术。
观察性、前瞻性、横向、描述性。
诊断为布罗德斯基3a型夏科氏神经病变的患者。2010年1月至2015年8月采用髓内阻挡钉行踝关节融合术进行手术治疗。
分析了16例患者。术前美国足与踝关节协会（AOFAS）评分为35.0±5.2分。术后随访4年7个月。术后AOFAS量表显示提高了40分（p = 0.0001）。
所提出的治疗方法可实现骨骼稳定，从而实现全足底支撑，并减少难以治疗的慢性溃疡的发生，是一种避免截肢的替代方法。
