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Treatment algorithm for Charcot foot and surgical technique with circular external fixation.

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Title: Treatment algorithm for Charcot foot and surgical technique with circular external fixation.
Authors: Rios-Ruh, J. M.1 tupieytobillo@gmail.com, Martin-Oliva, X.2, Santamaría-Fumas, A.1, Domínguez-Sevilla, A.1, López-Capdevila, L.1, Vilà y Rico, J.3, Sales-Pérez, J. M.1
Source: Acta Ortopédica Mexicana. Jan/Feb2018, Vol. 32 Issue 1, p7-12. 6p. 5 Color Photographs, 2 Charts.
Subjects: DIABETIC foot, EXTERNAL skeletal fixation (Surgery), DIABETES complications, OSTEOMYELITIS, DISEASE prevalence
Abstract (English): Background: Charcot neuroarthropathy (CNA), commonly known as Charcot foot, is one of the most debilitating complications of diabetes mellitus. Patients with plantar ulcer and osteomyelitis (OM) due to Charcot foot represent a high cost for health systems and society in general. The amputation risk for ulcerated Charcot patients is 12 times higher than general population under 65 years old. Material and methods: In this article we present the CNA treatment protocol we use in our center. We also make a detailed description of the surgical technique «single stage surgery» with circular external fixation. Results: Our CNA treatment protocol covers the most common presentations of this severe neuropathic complication. With the «single stage surgery» using circular external fi xation we achieve an ulcer-free foot, successful treatment of the OM, correction of the deformity, diminished the cost of treatment, avoided amputation and prevented recurrence of the ulcer. Conclusions: The use of a treatment algorithm based on the current literature, can be an invaluable tool in the treatment of these complex patients. The circular external fi xation has proven to be the only reliable tool for treating complex Charcot foot in the context of poor bone stock, active ulcers, soft tissues problems and OM. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes: La neuroartropatía de Charcot, comúnmente llamado «pie de Charcot», es una de las complicaciones más incapacitantes de la diabetes mellitus. Los pacientes con úlceras plantares y osteomielitis representan un gasto elevado para los diferentes sistemas de salud y la sociedad en general. El riesgo de amputación en estos pacientes es 12 veces más elevado que en la población general menor de 65 años. Material y métodos: En el presente trabajo mostramos el algoritmo de tratamiento de nuestro centro y también presentamos de manera detallada la técnica quirúrgica de un solo tiempo con fi jación externa circular. Resultados: Nuestro algoritmo de tratamiento cubre la mayor parte de las presentaciones clínicas de esta complicación. Con la cirugía en un solo tiempo y el uso de la fi jación externa circular se ha logrado desaparecer las úlceras, tratar satisfactoriamente la osteomielitis, corregir la deformidad, disminuir costos, prevenir recurrencias y evitar las amputaciones. Conclusiones: El uso de un algoritmo de tratamiento basado en la literatura actual es de suma utilidad para este grupo de pacientes. La fijación externa circular ha demostrado ser una herramienta confi able en el tratamiento integral de estos casos. [ABSTRACT FROM AUTHOR]
Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
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  Label: Title
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  Data: Treatment algorithm for Charcot foot and surgical technique with circular external fixation.
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  Data: <searchLink fieldCode="AR" term="%22Rios-Ruh%2C+J%2E+M%2E%22">Rios-Ruh, J. M.</searchLink><relatesTo>1</relatesTo><i> tupieytobillo@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Martin-Oliva%2C+X%2E%22">Martin-Oliva, X.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Santamaría-Fumas%2C+A%2E%22">Santamaría-Fumas, A.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Domínguez-Sevilla%2C+A%2E%22">Domínguez-Sevilla, A.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22López-Capdevila%2C+L%2E%22">López-Capdevila, L.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Vilà+y+Rico%2C+J%2E%22">Vilà y Rico, J.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Sales-Pérez%2C+J%2E+M%2E%22">Sales-Pérez, J. M.</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Ortopédica+Mexicana%22">Acta Ortopédica Mexicana</searchLink>. Jan/Feb2018, Vol. 32 Issue 1, p7-12. 6p. 5 Color Photographs, 2 Charts.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22DIABETIC+foot%22">DIABETIC foot</searchLink><br /><searchLink fieldCode="DE" term="%22EXTERNAL+skeletal+fixation+%28Surgery%29%22">EXTERNAL skeletal fixation (Surgery)</searchLink><br /><searchLink fieldCode="DE" term="%22DIABETES+complications%22">DIABETES complications</searchLink><br /><searchLink fieldCode="DE" term="%22OSTEOMYELITIS%22">OSTEOMYELITIS</searchLink><br /><searchLink fieldCode="DE" term="%22DISEASE+prevalence%22">DISEASE prevalence</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Background: Charcot neuroarthropathy (CNA), commonly known as Charcot foot, is one of the most debilitating complications of diabetes mellitus. Patients with plantar ulcer and osteomyelitis (OM) due to Charcot foot represent a high cost for health systems and society in general. The amputation risk for ulcerated Charcot patients is 12 times higher than general population under 65 years old. Material and methods: In this article we present the CNA treatment protocol we use in our center. We also make a detailed description of the surgical technique «single stage surgery» with circular external fixation. Results: Our CNA treatment protocol covers the most common presentations of this severe neuropathic complication. With the «single stage surgery» using circular external fi xation we achieve an ulcer-free foot, successful treatment of the OM, correction of the deformity, diminished the cost of treatment, avoided amputation and prevented recurrence of the ulcer. Conclusions: The use of a treatment algorithm based on the current literature, can be an invaluable tool in the treatment of these complex patients. The circular external fi xation has proven to be the only reliable tool for treating complex Charcot foot in the context of poor bone stock, active ulcers, soft tissues problems and OM. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Antecedentes: La neuroartropatía de Charcot, comúnmente llamado «pie de Charcot», es una de las complicaciones más incapacitantes de la diabetes mellitus. Los pacientes con úlceras plantares y osteomielitis representan un gasto elevado para los diferentes sistemas de salud y la sociedad en general. El riesgo de amputación en estos pacientes es 12 veces más elevado que en la población general menor de 65 años. Material y métodos: En el presente trabajo mostramos el algoritmo de tratamiento de nuestro centro y también presentamos de manera detallada la técnica quirúrgica de un solo tiempo con fi jación externa circular. Resultados: Nuestro algoritmo de tratamiento cubre la mayor parte de las presentaciones clínicas de esta complicación. Con la cirugía en un solo tiempo y el uso de la fi jación externa circular se ha logrado desaparecer las úlceras, tratar satisfactoriamente la osteomielitis, corregir la deformidad, disminuir costos, prevenir recurrencias y evitar las amputaciones. Conclusiones: El uso de un algoritmo de tratamiento basado en la literatura actual es de suma utilidad para este grupo de pacientes. La fijación externa circular ha demostrado ser una herramienta confi able en el tratamiento integral de estos casos. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Code: eng
        Text: English
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      – SubjectFull: DIABETIC foot
        Type: general
      – SubjectFull: EXTERNAL skeletal fixation (Surgery)
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      – SubjectFull: DIABETES complications
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      – SubjectFull: OSTEOMYELITIS
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      – SubjectFull: DISEASE prevalence
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