Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...

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Amputation Epidemiology 20X higher amputation rate vs. gen.l pop. Moss, et al: Diabetes Care 22: 1999 26% require an additional amputation 1/3 die within 1 yr. Dillingham, et al: Arch PMR 86: 2005
<strong>Diabetic</strong> salvage failure • poor control • poor compliance • poor physician recognition • lack <strong>of</strong> coordinated approach
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Evaluation & Treatment of Diabetic
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Objectives • discuss the musculos
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Diabetes; the “giving” disease
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Diabetes mellitus Epidemiology >65
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Neuropathy Epidemiology associated
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Neuropathy metabolic contribution:
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Neuropathy Autonomic dysfunction: a
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Neuropathy Immune dysfunction: maln
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Neuropathy treatment • maximize g
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Diabetic foot ulcer Epidemiology 15
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Ulcer formation pressure + neuropat
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depth Ulcer classification 0: “at
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Mechanical, structural factors •
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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 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 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
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Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...

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