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The consequences of complacency: managing the effects of unrecognized Charcot feet.
Diabet Med. 2011 Feb; 28(2):195-8.DM

Abstract

AIMS

Several authors have discussed an early prodromal state of neuroarthropathy (stage 0 Charcot) prior to the development of frank radiographic changes. However, very few reports are available that detail the outcomes of these patients. The purpose of this study was to report on the outcomes of patients with undetected early Charcot neuroarthropathy of the foot.

METHODS

Twenty patients, from two health science centres, were diagnosed retrospectively with stage 0 Charcot neuroarthropathy and were managed after referral from outside facilities. We evaluated any complications, including ulcer formation, infection, progression into active Charcot neuroarthropathy and the need for surgical reconstruction. Patients who did not progress to an active Charcot neuroarthropathy (Group I) were compared with those (Group II) who did progress to the destructive phase.

RESULTS

The diagnosis of Charcot neuroarthropathy was missed in 19 of 20 patients prior to referral. The average delay in treatment in Group I was 4.1±0.7 weeks compared with 8.7±6.8 weeks in Group II (Mann-Whitney U-test=24.5, n(1) =15, n(2) =7, P<0.05 two-tailed). Sixteen of 22 feet (72%) developed a complication during their treatment course. Group II experienced more complications than Group I (66.7% compared with 14.3%). Overall, eleven of 22 feet (50%) required surgical treatment; however, no patient required an amputation during the follow-up course.

CONCLUSIONS

This study reveals that outcomes of stage 0 Charcot neuroarthropathy feet depend on proper recognition and early management. To reduce the rate of future complications for Charcot foot should be the goal of all treatment.

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Authors+Show Affiliations

Wukich DK
Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. wukichdk@upmc.edu
Sung W
No affiliation info available
Wipf SA
No affiliation info available
Armstrong DG
No affiliation info available

MeSH

AmputationArthropathy, NeurogenicAttitude to HealthDiabetes Mellitus, Type 2Diabetic NeuropathiesEarly DiagnosisFemaleHumansMaleMiddle AgedRadiographyRetrospective StudiesTreatment Outcome

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

21219429

Citation

Wukich, D K., et al. "The Consequences of Complacency: Managing the Effects of Unrecognized Charcot Feet." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 28, no. 2, 2011, pp. 195-8.
Wukich DK, Sung W, Wipf SA, et al. The consequences of complacency: managing the effects of unrecognized Charcot feet. Diabet Med. 2011;28(2):195-8.
Wukich, D. K., Sung, W., Wipf, S. A., & Armstrong, D. G. (2011). The consequences of complacency: managing the effects of unrecognized Charcot feet. Diabetic Medicine : a Journal of the British Diabetic Association, 28(2), 195-8. https://doi.org/10.1111/j.1464-5491.2010.03141.x
Wukich DK, et al. The Consequences of Complacency: Managing the Effects of Unrecognized Charcot Feet. Diabet Med. 2011;28(2):195-8. PubMed PMID: 21219429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The consequences of complacency: managing the effects of unrecognized Charcot feet. AU - Wukich,D K, AU - Sung,W, AU - Wipf,S A M, AU - Armstrong,D G, PY - 2011/1/12/entrez PY - 2011/1/12/pubmed PY - 2011/6/3/medline SP - 195 EP - 8 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 28 IS - 2 N2 - AIMS: Several authors have discussed an early prodromal state of neuroarthropathy (stage 0 Charcot) prior to the development of frank radiographic changes. However, very few reports are available that detail the outcomes of these patients. The purpose of this study was to report on the outcomes of patients with undetected early Charcot neuroarthropathy of the foot. METHODS: Twenty patients, from two health science centres, were diagnosed retrospectively with stage 0 Charcot neuroarthropathy and were managed after referral from outside facilities. We evaluated any complications, including ulcer formation, infection, progression into active Charcot neuroarthropathy and the need for surgical reconstruction. Patients who did not progress to an active Charcot neuroarthropathy (Group I) were compared with those (Group II) who did progress to the destructive phase. RESULTS: The diagnosis of Charcot neuroarthropathy was missed in 19 of 20 patients prior to referral. The average delay in treatment in Group I was 4.1±0.7 weeks compared with 8.7±6.8 weeks in Group II (Mann-Whitney U-test=24.5, n(1) =15, n(2) =7, P<0.05 two-tailed). Sixteen of 22 feet (72%) developed a complication during their treatment course. Group II experienced more complications than Group I (66.7% compared with 14.3%). Overall, eleven of 22 feet (50%) required surgical treatment; however, no patient required an amputation during the follow-up course. CONCLUSIONS: This study reveals that outcomes of stage 0 Charcot neuroarthropathy feet depend on proper recognition and early management. To reduce the rate of future complications for Charcot foot should be the goal of all treatment. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/21219429/The_consequences_of_complacency:_managing_the_effects_of_unrecognized_Charcot_feet_ L2 - https://doi.org/10.1111/j.1464-5491.2010.03141.x DB - PRIME DP - Unbound Medicine ER -