Short Daniel J, Zgonis Thomas
Mid-Atlantic Permanente Medical Group, Springfield Medical Center, 6501 Loisdale Court, Springfield, VA 22150, USA.
Division of Podiatric Medicine and Surgery, Department of Orthopaedics, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, MSC 7776, San Antonio, TX 78229, USA.
Clin Podiatr Med Surg. 2017 Jul;34(3):381-387. doi: 10.1016/j.cpm.2017.02.008. Epub 2017 Mar 22.
Bone loss and destruction due to diabetic Charcot neuroarthropathy (CN) and osteomyelitis of the foot and ankle is a challenging clinical condition when lower extremity preservation is considered. Resection and excision of osteomyelitis and associated nonviable soft tissue can lead into large osseous and soft tissue defects that will most likely need the utilization of bone grafting and subsequent arthrodesis for stability and anatomic alignment. In the diabetic population with peripheral neuropathy, osseous instability can lead to subsequent lower extremity deformity, ulceration, infection and/or amputation. This article reviews the surgical approach in the presence of diabetic CN and concomitant osteomyelitis.
当考虑保留下肢时，糖尿病夏科氏神经关节病（CN）以及足踝部骨髓炎所导致的骨质流失和破坏是一种具有挑战性的临床病症。切除骨髓炎及相关的无活力软组织会导致大面积的骨与软组织缺损，很可能需要采用骨移植及随后的关节融合术来实现稳定性和解剖学对线。在患有周围神经病变的糖尿病患者中，骨质不稳定会导致随后的下肢畸形、溃疡、感染和/或截肢。本文回顾了存在糖尿病性CN并伴有骨髓炎时的手术方法。
