Diabetic Charcot's Foot Complicated by Foot Ulcer and Unusual Bone Fractures: Report of Three Cases.
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Diabetic Charcot's foot complicated by unusual bone dislocation and fracture is reported in three neuropathic patients. Case 1, a 65-year-old man with NIDDM of 35 years duration presented with a plantar ulcer which was caused by the protrusion of the cuboid bone to the sole. A foot print test confirmed an abnormally high pressure loading at the center of the foot ulcer. The position, vibration and pain senses were all markedly diminished in both feet. Cutting off the tip of the dislocated cuboid bone and employing an insole to avoid abnormal pressure loading were effective in healing the ulcer. Case 2 (a 40-year-old man) and Case 3 (a 39-year-old woman), both with chronic renal failure and Charcot's foot, both developed unique painless calcaneal fractures following minor trauma to the feet. The small bone fragment of the posterior limb of the calcaneus was distracted upward by the Achilles tendon in both cases. In addition to the bone fragility secondary to renal osteodystrophy, the lack of pain and proprioceptive sense supposedly plays an important role in the occurrence of these pathological fractures.<BR>Charcot's foot results from advanced diabetic neuropathy and easily results in further damage anddisability. Therefore, the routine management of Charcot's foot should include careful observationof the foot and the patient's gait pattern, assessment of the foot pressure distribution and earlyapplication of appropriate footwear and insoles.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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