Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...
Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ... Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...
Neuroarthropathy • Jean-Martin Charcot (1868) 1 st described neuropathic changes in a syphilitic patient; disease of “trophic centers” of anterior horn cells • Jordan (1936) 1 st described diabetic neuropathy • Bailey (1942) tarsal destruction in 14 uncontrolled DM
Neuroarthropathy • bony destruction in neuropathic patients • associated instability • ulceration 2° to bony prominence • confused with: cellulitis osteomyelitis acute fracture
- 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 40 and 41: Off-loading • pressure prevents u
- 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 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
- Page 91 and 92: Vascular Endocrine Orthopedics Woun
<strong>Neuroarthropathy</strong><br />
• Jean-Martin Charcot (1868)<br />
1 st described neuropathic changes in a<br />
syphilitic patient; disease <strong>of</strong> “trophic<br />
centers” <strong>of</strong> anterior horn cells<br />
• Jordan (1936)<br />
1 st described diabetic neuropathy<br />
• Bailey (1942)<br />
tarsal destruction in 14 uncontrolled DM
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