Evaluation and Treatment of Diabetic Neuroarthropathy - Medical ...

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Conclusions Charcot treatment recognize stages recognize at-risk patients acute surgery for dislocation, skin at risk reconstruction for chronic instability, nonbraceble deformity protective orthotics, braces shoewear education
Vascular Endocrine Orthopedics Wound care Limb preservation in the diabetic, neuropathic patient Radiology Plastics Primary Care Foot Program PM & R Physical Therapy
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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
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Circulation Waveform characteristic
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Infection • screening labs CBC, E
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Infection
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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 82 and 83: Amputation Epidemiology 20X higher
Page 84: Limb salvage vs. amputation • wil
Page 87 and 88: Conclusions Ulcer treatment pressur
Page 89: Conclusions Charcot treatment redne
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