Abstract
The main task of conservative therapy of Charcot neuroarthropathy is to arrest the inflammatory process of active neuroarthropathy by mechanical stabilization of the foot skeleton and thus to initiate the phase of bony consolidation. Plaster techniques and ankle-foot-orthoses are primarily available for this purpose. The latter are used as prefabricated aids in the case of non-deformed or only slightly deformed feet, or as individually fitted orthoses in the presence of a deformity. This type of conservative therapy can be an alternative to surgical treatment after an appropriate risk-benefit assessment, or it can provide additional protection following surgical reconstructive measures until the arthrodeses produced by external or internal fixation methods are firmly fused. And this period is twice as long in the presence of polyneuropathy as with standard procedures.
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References
Koller A, Springfeld R, Engels G, et al. German-Austrian consensus on operative treatment of Charcot neuroarthropathy: a perspective by the Charcot task force of the German Association for Foot Surgery [published correction appears in Diabet Foot Ankle. 2011;2. doi: 10.3402/dfa.v2i0.14920]. Diabet Foot Ankle. 2011;2. https://doi.org/10.3402/dfa.v2i0.10207.
Petrova NL, Petrov PK, Edmonds ME, Shanahan CM. Inhibition of TNF-α reverses the pathological resorption pit profile of osteoclasts from patients with acute Charcot osteoarthropathy. J Diabetes Res. 2015;2015:917945. https://doi.org/10.1155/2015/917945. Epub 2015 Jun 2. PMID: 26137498; PMCID: PMC4468294.
Game FL, Catlow R, Jones GR, et al. Audit of acute Charcot’s disease in the UK: the CDUK study. Diabetologia. 2012;55:32–5.
Böhler L. Technik der Knochenbruchbehandlung. Wien: Wilhelm Maudrich Publisher; 1929. (Technique of fracture treatment).
Kaynak G, Birsel O, Güven MF, Oğüt T. An overview of the Charcot foot pathophysiology. Diabetic Foot Ankle. 2013;4. https://doi.org/10.3402/dfa.v4i0.21117.
Morgan JM, BiehlL WC, Wagner FW Jr. Management of neuropathic arthropathy with the Charcot restraint orthotic walker. Clin Orthop. 1993;296:58–63.
Saltzman CL, Hagy ML, Zimmerman B, et al. How effective is intensive nonoperative initial treatment of patients with diabetes and Charcot arthropathy of the feet? Clin Orthop. 2005;435:185–90.
Saltzman CL, Johnson KA, Goldstein RH, et al. The patellar tendon-bearing brace as treatment for neurotrophic arthropathy: a dynamic force monitoring study. Foot Ankle. 1992;13(1):14–21.
Jeffcoate WJ, Game F, Cavanagh PR. The role of proinflammatory cytokines in the cause of neuropathic osteoarthropathy (acute Charcot foot) in diabetes. Lancet. 2005;366(9502):2058–61. https://doi.org/10.1016/S0140-6736(05)67029-8. Epub 2005 Aug 10. PMID: 16338454.
Guyton GP. An analysis of iatrogenic complications from the TCC. Foot Ankle Int. 2005;26(11):903–7.
Piaggesi A, Macchiarini S, Rizzo L, Palumbo F, Tedeschi A, Nobili LA, Leporati E, Scire V, Teobaldi I, Del Prato S. An off-the-shelf instant contact casting device for the management of diabetic foot ulcers: a randomized prospective trial versus traditional fiberglass cast. Diabetes Care. 2007;30(3):586–90.
Dahmen R, et al. Therapeutic footwear for the neuropathic foot: an algorithm. Diabetes Care. 2001;24(4):705–9.
Wu T, Chen PY, Chen CH, Wang CL. Doppler spectrum analysis: a potentially useful diagnostic tool for planning the treatment of patients with Charcot arthropathy of the foot? J Bone Joint Surg Br. 2012;94(3):344–7.
Armstrong DG, Lavery LA. Monitoring healing of acute Charcot’s arthropathy with infrared dermal thermometry. J Rehabil Res Dev. 1997;34:317.
Schon LC, Easley ME, Weinfeld SB. Charcot neuroarthropathy of the foot and ankle. Clin Orthop Relat Res. 1998;349:116–31.
Rajapakse C, et al. Thermography in the assessment of peripheral joint inflammation—a re-evaluation. Rheumatol Rehabil. 1981;20(2):81–7.
Zampa V, et al. Role of dynamic MRI in the follow-up of acute Charcot foot in patients with diabetes mellitus. Skelet Radiol. 2011;40:991–9.
Berli MC, et al. The “Balgrist Score” for evaluation of Charcot foot. Skelet Radiol. 2021;50:311–20.
Eichenholtz SN. Charcot joints. Springfield, IL: Charles C Thomas; 1966.
Sanders LJ, Frykberg RG. The Charcot foot (Pied de Charcot). In: Bowker JH, Pfeifer MA, editors. Levin and O’Neal’s the diabetic foot. 7th ed. Philadelphia: Mosby Elsevier; 2007. p. 257–83.
Sinacore DR. Acute Charcot arthropathy in patients with diabetes mellitus: healing times by foot location. J Diabetes Complicat. 1998;12(5):287–93. https://doi.org/10.1016/s1056-8727(98)00006-3. PMID: 9747646.
Armstrong DG, Lavery LA. Acute Charcot’s arthropathy of the foot and ankle. Phys Ther. 1998;78(1):74–80.
Jones KB, Maiers-Yelden KA, Marsh JL, Zimmerman MB, Estin M, Saltzman CL. Ankle fractures in patients with diabetes mellitus. J Bone Joint Surg Br. 2005;87(4):489–95.
Marks RM. Complications of foot and ankle surgery in patients with diabetes. Clin Orthop Relat Res. 2001;(391):153–61.
Koller A, Kersken J. Hilfsmittel beim Diabetischen Fußsyndrom. Orthopädie-Technik. 2013;7:1–6.
Koller A, Meissner SA, Podella M, Fiedler R. Orthotic management of Charcot feet after external fixation surgery. Clin Podiatr Med Surg. 2007;24(3):583–99.
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Koller, A. (2023). Charcot Foot: Conservative Management. In: Attinger, C.E., Steinberg, J.S. (eds) Functional Limb Salvage. Springer, Cham. https://doi.org/10.1007/978-3-031-27725-2_18
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