[Surgical management of neuropathy and osteoarthropathy of the diabetic food].
Along with angiopathy, neuropathy and osteoarthropathy are the most important effects of diabetes mellitus with regard to the foot. Because diagnosis in cases of these two consequences are very frequently wrong and too late, the diagnostic procedure and differential diagnosis will be discussed first. The goal of surgical and conservative treatment is a functioning foot and not amputation and provision of a prosthesis. The five types of osteoarthropathy together with the operative procedure for each are introduced: at the forefoot, resection of from one to all metatarsal radii whilst sparing the toes; at the metatarsus, the removal of projecting fragments; at the dorsal foot, resectioning arthroplasty. The operative procedures usual in traumatology cannot simply be transferred to osteoarthropathy. Arthrodeses and spongiosa grafting are doomed to failure in the neuropathic area, or at least carry the onus of a much longer period of convalescence. Resectioning arthroplasty for constructing a stiff pseudarthrosis is an alternative. The results are, however, only lasting if perfect orthopedic care and regular care and checking of the feet are guaranteed thereafter.
Baumgartner
R
R
Klinik für Technische Orthopädie und Rehabilitation, Westfälischen Wilhelms-Universität Münster.
D001177:Arthropathy, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017719:Diabetic Foot / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D019637:Orthopedic Procedures; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011379:Prognosis
Chirurgisches Vorgehen bei Neuropathie und Osteoarthropathie des diabetischen Fusses.