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慢性治疗抵抗性双侧夏科氏足骨关节炎伴骨髓炎迹象的挽救治疗

Salvage of Chronic Therapy-Resistant Bilateral Charcot Foot Osteoarthropathy with Signs of Osteomyelitis.

作者信息

Kidron Ariel, Nguyen Hiep H, Bayer Jack, Durkin Michael, Harris Daniel, Dang Helen, Diehl Matt, Silver Larry

机构信息

Orthopaedic Surgery, Nova Southeastern University Osteopathic Medicine College of Medicine, Ft. Lauderdale, Florida, USA.

Orthopaedic Surgery, Dr. Kiran C. Patel College of Allopathic Medicine, Ft. Lauderdale, Florida, USA.

出版信息

Orthop Surg. 2022 Jul;14(7):1541-1544. doi: 10.1111/os.13299. Epub 2022 May 19.

Abstract

Charcot arthropathy is an insidious condition affecting the lower limbs of diabetic patients. It is a complication of diabetic neuropathy resulting from subsequent Wallerian degeneration of the nerves. This complication may eventually lead to limb amputation and a poor patient prognosis if not diagnosed and treated successfully. Herein, we report the case of a 73-year-old female who presented with rapidly progressive bilateral Charcot foot over a 5-week period, necessitating an exostectomy on the mid foot, specifically on the cuboid bone and the navicular cuneiform joint. Her presentation with rapidly progressing foot ulcers on the plantar aspect prompted initial treatment based on osteomyelitis. The report will therefore serve as a useful guide on how to properly treat Charcot foot, which may present in an atypical manner.

摘要

夏科氏关节病是一种隐匿性疾病,影响糖尿病患者的下肢。它是糖尿病神经病变的并发症,由神经随后的沃勒变性引起。如果不能成功诊断和治疗,这种并发症最终可能导致肢体截肢和患者预后不良。在此,我们报告一例73岁女性病例,该患者在5周内出现快速进展的双侧夏科氏足,需要对中足,特别是骰骨和舟楔关节进行外生骨疣切除术。她足底出现快速进展的足部溃疡,促使最初基于骨髓炎进行治疗。因此,本报告将为如何正确治疗可能以非典型方式出现的夏科氏足提供有用的指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e437/9251323/af64a2942967/OS-14-1541-g001.jpg

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