Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...
Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ... Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...
Off-loading • pressure prevents ulcer healing !! • location of ulcer determines type of immobilization relief shoe with plastazote lining boot brace with plastazote lining total contact cast • assist device to help unweight
Total contact cast • edema control device • vertical forces distributed over sole • shear forces reduced • labor-intensive • prevents local wound care Laing, et al: JBJS 74: 1992
- Page 1 and 2: Evaluation & Treatment of Diabetic
- Page 3 and 4: Objectives • discuss the musculos
- Page 5 and 6: Diabetes; the “giving” disease
- Page 7 and 8: Diabetes mellitus Epidemiology >65
- Page 9 and 10: Neuropathy Epidemiology associated
- Page 11 and 12: Neuropathy metabolic contribution:
- Page 13 and 14: Neuropathy Autonomic dysfunction: a
- Page 15 and 16: Neuropathy Immune dysfunction: maln
- Page 17 and 18: Neuropathy treatment • maximize g
- Page 19 and 20: Diabetic foot ulcer Epidemiology 15
- Page 21: Ulcer formation pressure + neuropat
- Page 24 and 25: depth Ulcer classification 0: “at
- Page 26: Mechanical, structural factors •
- Page 30 and 31: Sensation Monofilament testing 5.07
- Page 32 and 33: Circulation Waveform characteristic
- Page 34 and 35: Infection • screening labs CBC, E
- Page 36 and 37: Infection
- Page 38 and 39: Healing potential Screening labs to
- Page 42 and 43: Total contact cast
- Page 44 and 45: Protection
- Page 46 and 47: Exostectomy
- Page 48 and 49: Exostectomy
- Page 50 and 51: Reconstruction
- Page 52 and 53: Neuroarthropathy • Jean-Martin Ch
- Page 54 and 55: Neuroarthropathy Typical scenario i
- Page 58 and 59: Neuroarthropathy • “no ulcer -
- Page 60 and 61: Neuroarthropathy “at-risk” fact
- Page 62 and 63: Etiology Neurovascular theory neura
- Page 64: stage I Charcot • x-ray: fragment
- Page 67 and 68: stage III Charcot • x-ray: recons
- Page 69 and 70: Neuroarthropathy Treatment goals cr
- Page 71 and 72: Charcot acute treatment • strict
- Page 73 and 74: Stage II treatment • protected we
- Page 76: Surgical indications • gross inst
- Page 82 and 83: Amputation Epidemiology 20X higher
- Page 84: Limb salvage vs. amputation • wil
- Page 87 and 88: Conclusions Ulcer treatment pressur
- Page 89 and 90: Conclusions Charcot treatment redne
Total contact cast<br />
• edema control device<br />
• vertical forces distributed over sole<br />
• shear forces reduced<br />
• labor-intensive<br />
• prevents local wound care<br />
Laing, et al: JBJS 74: 1992