C Stark1, T Murray1, C Gooday2, I Nunney1, R Hutchinson3, D Loveday3, K Dhatariya4. 1. Norwich Medical School, University of East Anglia, Norwich, UK. 2. Diabetic Foot Clinic, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. 3. Department of Orthopaedic Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. 4. Diabetic Foot Clinic, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. Electronic address: ketan.dhatariya@nnuh.nhs.uk.
Abstract
BACKGROUND: Few data describe the natural history of Charcot neuroarthropathy treated with a total contact plaster cast (TCC). METHODS: A 5 year retrospective analysis of 50 patients presenting with an acute CN, Assessing time to clinical resolution into appropriate footwear and assessing if initial immobilisation device influenced resolution time. RESULTS: During the study period 42 patients (84%) of patients went into remission, 2 died during their treatment, 4 had major amputations, in 2 patients treatment was ongoing. 36 patients were treated with combination offloading devices, 6 were treated with one modality only. Median time to resolution for patients initially treated with a TCC was not significantly shorter than for those treated with a removable below knee boot. 34.9% required re-casting due to clinical deterioration in the removable device. CONCLUSIONS: More precise measures of resolution of CN are needed to assess the impact of initial treatment modality on time to resolution.
BACKGROUND: Few data describe the natural history of Charcot neuroarthropathy treated with a total contact plaster cast (TCC). METHODS: A 5 year retrospective analysis of 50 patients presenting with an acute CN, Assessing time to clinical resolution into appropriate footwear and assessing if initial immobilisation device influenced resolution time. RESULTS: During the study period 42 patients (84%) of patients went into remission, 2 died during their treatment, 4 had major amputations, in 2 patients treatment was ongoing. 36 patients were treated with combination offloading devices, 6 were treated with one modality only. Median time to resolution for patients initially treated with a TCC was not significantly shorter than for those treated with a removable below knee boot. 34.9% required re-casting due to clinical deterioration in the removable device. CONCLUSIONS: More precise measures of resolution of CN are needed to assess the impact of initial treatment modality on time to resolution.
Authors: Vladimíra Fejfarová; Jaroslav Pavlů; Robert Bém; Veronika Wosková; Michal Dubský; Andrea Němcová; Alexandra Jirkovská; Bedřich Sixta; Karol Sutoris; Filip Thieme; David G Armstrong; Eliška Vrátná; Jitka Hazdrová; Věra Lánská Journal: J Diabetes Res Date: 2019-09-15 Impact factor: 4.011