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Pathophysiologie und Ätiologie des Charcot-Fußes

Pathophysiology and etiology of the Charcot foot

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Zusammenfassung

Hintergrund

Die Pathophysiologie des Charcot-Fußes ist trotz intensiver Forschung soweit nicht endgültig geklärt. Vor allem Diagnoseverzögerung und Fehlbehandlung können zu weitreichenden Folgen für den Patienten führen.

Fragestellung

Unterschiedliche Theorien zur Pathogenese des Charcot-Fußes werden dargestellt und erläutert.

Material und Methode

Im Artikel werden Theorien zur Pathogenese des Charcot-Fußes, Studien auf zellulärer Ebene, im Bereich der Immunologie und des Knochenstoffwechsels behandelt.

Ergebnisse

Es gibt einerseits die Theorie, dass durch repetitive Mikrotraumen im sensorisch beeinträchtigten Fuß die Ausbildung der Neuropathie verursachen. Dem gegenüber steht die neurovaskuläre Theorie, die besagt, dass durch eine Fehlinnervation der Blutgefäße die morphologischen Veränderungen im Charcot-Fuß verursacht werden. Es scheint ein Zusammenwirken beider Mechanismen die pathophysiologische Grundlage sein.

Schlussfolgerungen

Der Charcot-Fuß wird durch eine Kombination von mechanischen, vaskulären und biologischen Faktoren ausgelöst und führt bei zu später Diagnose und falscher Behandlung zur massiven Destruktion des Fußes.

Abstract

Background

Despite extensive research, the pathophysiology of Charcot foot is still not fully understood. In the case of late diagnosis and insufficient therapy, severe deformity may occur.

Objectives

Different theories on the pathophysiology of the Charcot foot are presented and discussed.

Materials and methods

This article presents different theories on the pathophysiology of the Charcot foot and presents studies on the cellular, immunological, and bone metabolism level.

Results

One theory is based on repetitive microtraumas in the sensoric deficient foot which lead to development of Charcot foot. Another theory is based on pathologic neurovascular innervation leading to morphologic changes. Probably both mechanisms are responsible in combination as etiological factors inducing neuropathy

Conclusion

A combination of mechanical, vascular, and biologic factors induce the neuropathic foot and result in severe deformity if diagnosis is too late.

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Authors and Affiliations

  1. Abteilung für Orthopädie und orthopädische Chirurgie, Klinikum Wels-Grieskirchen, Grieskirchnerstr. 42, 4600, Wels, Österreich

    K. Trieb & S.G. Hofstätter

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  1. K. Trieb
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  2. S.G. Hofstätter
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Correspondence to K. Trieb.

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Interessenkonflikt

K. Trieb und S.G. Hofstätter geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Trieb, K., Hofstätter, S. Pathophysiologie und Ätiologie des Charcot-Fußes. Orthopäde 44, 2–7 (2015). https://doi.org/10.1007/s00132-014-3049-9

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  • DOI: https://doi.org/10.1007/s00132-014-3049-9

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