Tisdel C L, Marcus R E, Heiple K G
Department of Orthopaedics, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
Foot Ankle Int. 1995 Jun;16(6):332-8. doi: 10.1177/107110079501600604.
From 1963 to 1990, the senior authors (R.E.M. and K.G.H.) performed eight triple arthrodeses in seven patients with diabetes mellitus with sensory loss in the lower extremities. By clinical and roentgenographic examination, all patients were diagnosed with peritalar neuroarthropathy before surgery. All patients underwent a two-incision triple arthrodesis with internal fixation. Patient follow-up averaged 44 months and included repeat physical examinations and radiographs. All patients went on to clinical union and were satisfied with the procedure. One patient had prolonged wound drainage that resolved with antibiotic therapy; another had a residual rocker-bottom deformity and plantar ulceration that resolved after modification of custom shoe wear. We believe comprehensive management of diabetic peritalar neuroarthropathy can include surgical arthrodesis of the involved joints. The disease process and surgical indications are discussed.
1963年至1990年期间，资深作者（R.E.M.和K.G.H.）对7例患有糖尿病且下肢感觉丧失的患者实施了8例三关节融合术。通过临床和影像学检查，所有患者在手术前均被诊断为距周神经性关节病。所有患者均接受了双切口三关节融合术并进行内固定。患者随访平均44个月，包括重复体格检查和X光片检查。所有患者均实现临床愈合，对手术满意。1例患者伤口引流时间延长，经抗生素治疗后缓解；另1例患者残留摇椅底畸形和足底溃疡，在定制鞋具改良后得到缓解。我们认为，糖尿病距周神经性关节病的综合治疗可包括对受累关节进行手术融合。本文讨论了该疾病的病程及手术指征。
