Kosinski M, Ramcharitar S
Department of Medicine, New York College of Podiatric Medicine.
Geriatrics. 1994 May;49(5):43-7; quiz 48-9.
Foot disorders can be a major source of pain, discomfort, and disability for older adults. Neuropathy, impaired leukocyte function, vascular insufficiency, and trauma predispose older diabetics to limb-threatening complications. Therefore, examine the diabetic patient's foot during each visit. Painful foot disorders and lower extremity joint impairment represent major causes of treatable gait disturbance. Treatment of hyperkeratotic lesions (corns, calluses) consists of aseptic debridement and weight dispersion. Interspace maceration, fungal infections, and ulceration must also be managed with care. It is important to distinguish mycotic nail infections from nail dystrophies secondary to systemic disease, vascular insufficiency, and trauma.
足部疾病可能是老年人疼痛、不适和残疾的主要来源。神经病变、白细胞功能受损、血管功能不全和创伤使老年糖尿病患者易发生威胁肢体的并发症。因此，每次就诊时都要检查糖尿病患者的足部。足部疼痛性疾病和下肢关节损伤是可治疗的步态障碍的主要原因。治疗角化过度性病变（鸡眼、胼胝）包括无菌清创和分散体重。趾间浸渍、真菌感染和溃疡也必须谨慎处理。区分霉菌性指甲感染与继发于全身性疾病、血管功能不全和创伤的指甲营养不良很重要。
