Breaking News
September 22, 2018 - Finding epigenetic signature appears to predict inflammation risk in serious type of IBD
September 22, 2018 - Researchers develop light-based technique to measure very weak magnetic fields
September 22, 2018 - UAB researchers study dysfunction of the immune system associated with NSAID carprofen
September 22, 2018 - QIAGEN and DiaSorin launch automated, CE-marked workflow for high-throughput TB screening
September 22, 2018 - Cardiac MR With Contrast Feasible in Developing World
September 22, 2018 - Daily low-dose aspirin doesn’t reduce heart-attack risk in healthy people
September 21, 2018 - Children with asthma found to be disadvantaged in education and future occupation
September 21, 2018 - Interaction of chemical slurry and ancient shale in fracking wastewater causes radioactivity
September 21, 2018 - Researchers find that sample size is key factor determining accuracy of study results
September 21, 2018 - Study shows how the drive to eat overpowers the brain’s signal to stop
September 21, 2018 - 30 Million Americans Now Have Diabetes
September 21, 2018 - Thousands of breast cancer gene variants engineered and analyzed
September 21, 2018 - The current fellowship interview process is cumbersome — Stanford researchers have a better idea
September 21, 2018 - Progenitor cells for human bone and cartilage have been identified
September 21, 2018 - Study reveals new therapeutic target for pediatric tumor-associated intractable epilepsy
September 21, 2018 - SLU’s College professor receives NIH grant to develop I-TEST project
September 21, 2018 - DermTech completes enrollment in clinical study to assess DNA damage and reversal
September 21, 2018 - Grieving patients treated with talk therapy have lower risk of suicide and psychiatric illness
September 21, 2018 - NIH and FDA call for eliminating involvement of RAC in human gene therapy experiments
September 21, 2018 - New system uses algorithm to convert 2D videos into 3D printed ‘motion sculptures’
September 21, 2018 - Sea squirt model reveals key molecules in dopaminergic neuron differentiation
September 21, 2018 - Effective management of neonatal abstinence syndrome requires coordinated ‘cascade of care’
September 21, 2018 - Refugees seek care for wounds of war
September 21, 2018 - Under the sea, in an octopus’ garden on ecstacy
September 21, 2018 - Eating foods with low nutritional quality ratings linked to cancer risk in large European cohort
September 21, 2018 - Giving kids honest information about water consumption may help them make healthy choices
September 21, 2018 - Horwitz Prize Awarded for Work on Hormones
September 21, 2018 - CHMP issues positive opinion supporting use of Trelegy Ellipta in broader group of COPD patients
September 21, 2018 - Scientists discover new molecules that work together to remove unwanted DNA
September 21, 2018 - Dr. Fenella France to deliver 2019 Plenary Lecture
September 21, 2018 - New research finds that MHC-II molecules have more influence on tumors than MHC-I
September 21, 2018 - Researchers study effects of cardiac cycle in simple learning task
September 21, 2018 - FDA takes new steps to address opioid crisis by approving Opioid Analgesic Risk Evaluation and Mitigation Strategy
September 21, 2018 - Positive Barhemsys Phase 3 Treatment Data Published in Anesthesia & Analgesia
September 21, 2018 - Celiac Disease Screening: MedlinePlus Lab Test Information
September 21, 2018 - Autism linked to egg cells’ difficulty creating large proteins
September 21, 2018 - Tweaking nuclear pores could provide new avenue to battle against cancer
September 21, 2018 - Experts warn health care providers to slow down in allowing smart pill in patient care settings
September 21, 2018 - MoreGrasp reports breakthrough development of grasp neuroprosthetics activated by thought control
September 21, 2018 - Study reveals new way to target HER2-negative metastatic breast cancer
September 21, 2018 - CHMP grants positive opinion for VENCLYXTO plus rituximab for treating relapsed/refractory CLL
September 21, 2018 - Study offers solid link between visceral organs and brain’s reward, motivation system
September 21, 2018 - First U.S. patient treated with innovative gene therapy at Bascom Palmer Eye Institute
September 21, 2018 - New study shows how Ethiopia has managed to achieve extraordinary progress
September 21, 2018 - Choroidal Detachment – The American Society of Retina Specialists
September 21, 2018 - New clinical trial evaluates aesthetic results of conservative surgery in breast cancer
September 21, 2018 - Discovery of a key protein involved in the development of autism
September 21, 2018 - Air pollution appears to be linked to increased risk of developing dementia
September 21, 2018 - Henry Ford Health System receives $600k grant to study genetic makeup of gliomas
September 21, 2018 - Arthritis common in individuals with varying degrees of depression, finds study
September 21, 2018 - Scientist intends to fight pathogenic bacteria with viruses
September 21, 2018 - New research suggests link between PFAS chemicals and hyperthyroidism in pet cats
September 21, 2018 - Multi-year study data shows impact of new soft contact lens to slow myopia progression in children
September 21, 2018 - Neuroscientists identify circuit for brain’s statistical inference about motion
September 21, 2018 - MILabs’ VECTor6 system wins Commercial Innovation Award at WMIC 2018
September 21, 2018 - Scientists find wild African monkeys infected with bacterium that causes syphilis, yaws in humans
September 21, 2018 - 2006 to 2015 Saw Increase in Severe Maternal Morbidity
September 21, 2018 - Similar changes in the brains of patients with ADHD and emotional instability
September 21, 2018 - Cobalt mining in DR Congo takes a high toll on both creuseurs and environment
September 21, 2018 - Eating fatty fish during pregnancy may boost unborn child’s brain development
September 21, 2018 - Study reveals promising new drug candidate to treat acute renal failure
September 21, 2018 - Neural signal that urges to eat overpowers the one that says to stop
September 21, 2018 - Scientists achieve breakthrough in accelerated diagnosis of multi-resistant hospital pathogens
September 21, 2018 - Researchers simulate how different breast tissues respond to heat from MRIs
September 21, 2018 - Despite red flags at surgery centers, overseers award gold seals
September 21, 2018 - Zapping Airway Nerves May Help COPD Patients Breathe
September 21, 2018 - Researchers find answers as to why some people are at risk of gout
September 21, 2018 - Stars of Stanford Medicine: Genetic counseling and compassion
September 21, 2018 - Researchers use reinforcement learning to train gliders to soar like birds
September 21, 2018 - New federally-funded research project could lead to treatments that extend human lifespan
September 21, 2018 - Health insurance ads have shifted over time due to health plans offered via ACA
September 21, 2018 - Use of transcranial electrical stimulation to bolster creativity has far-reaching implications
September 21, 2018 - Scientists find way to boost efficacy of powerful antimalarial drug with anti-cancer medicines
September 21, 2018 - Weighing the risks and benefits of drug tapering—two patients, two perspectives
September 21, 2018 - The “exposome” revealed: a barrage of bacteria, chemicals, microscopic animals and more
September 21, 2018 - Top three immune boosting recommendations to ward off freshers’ flu
September 21, 2018 - Young children’s oral microbiota could serve as early indicator for obesity
September 21, 2018 - Older individuals with multiple sclerosis report higher quality of life than younger counterparts
September 21, 2018 - LineaRx signs agreement with Takis/Evvivax to develop linear-DNA based anti-cancer vaccines
September 21, 2018 - AbbVie Presents Upadacitinib Longer-Term (32-Week) and Patient-Reported Outcomes Data from Phase 2b Atopic Dermatitis Study at 27th European Academy of Dermatology and Venereology (EADV) Congress
Loyola Medicine study finds high success rate for diabetic Charcot foot surgery

Loyola Medicine study finds high success rate for diabetic Charcot foot surgery

image_pdfDownload PDFimage_print

Nearly four out of five diabetic patients with severe cases of a disabling condition called Charcot foot were able to walk normally again following surgery, a Loyola Medicine study has found.

The study by orthopaedic surgeons Michael Pinzur, MD, and Adam Schiff, MD, is published in Foot & Ankle International, the official journal of the American Orthopaedic Foot & Ankle Society.

The growing number of diabetics, combined with the obesity epidemic, is increasing the incidence of Charcot foot. The condition typically occurs in diabetics who have neuropathy (nerve damage), which impairs the ability to feel foot pain. Charcot foot usually develops following a minor injury, such as a sprain or stress fracture. Because the patient doesn’t feel the injury, he or she continues to walk, making the injury worse. This can cause a deformity, or malposition of the foot, which eventually can lead to ulcers and infections of the bone.

“Charcot foot is a debilitating condition that is very challenging to treat,” Dr. Pinzur said. “But with the proper surgical treatment, most patients will be able to walk normally again.”

Loyola Medicine has one of the leading programs in the country for treating Charcot foot, also called diabetic foot or Charcot arthropathy. Loyola takes an integrated approach, combining the expertise of orthopaedic surgeons, podiatrists, endocrinologists and other specialists.

Most patients can be treated successfully by immobilizing the foot. But a small percentage of patients, such as those in the Loyola study, develop severe deformities or bone infections.

Traditionally, a successful treatment for a severe case of Charcot foot was defined as clearing up the infection and preventing a foot amputation. The Loyola study used a stricter standard: in addition to resolving the infection and saving the foot, the patient had to be able to walk outside the home with the use of commercially available therapeutic footwear. Using this higher standard, 77.6 percent of the feet had favorable outcomes following surgery.

The study was a retrospective examination of 214 Charcot foot patients who underwent surgery by Dr. Pinzur over a 12-year period. (Nine patients underwent operations on both feet.) Overall, 173 of the 223 feet had good or excellent outcomes. An excellent outcome was defined as being free of ulcers and infections and able to walk outside the home using off-the-shelf therapeutic footwear and custom foot braces. A good outcome was defined as being infection- and ulcer-free and able to walk outside the home with either a custom shoe modification and/or a short ankle-foot brace.

Seven patients died of unrelated causes within a year of surgery and 15 underwent partial- or whole-foot amputations.

Success rates varied according to the type of Charcot foot deformity. Patients with a valgus deformity pattern had the highest success rate (87 percent). The success rate was 70.3 percent among patients with a dislocation pattern deformity and 56.3 percent with a varus deformity pattern.

A common treatment for severe Charcot foot is to put the patient in a cast. But bones can heal in deformed positions. It also is difficult or impossible for obese patients to walk on one leg when the other leg is in a cast. Patients typically have to use wheelchairs for as long as nine months, and after the cast comes off, they must wear a cumbersome leg brace.

However, traditional surgical techniques, in which bones are held in place by internal plates and screws, also are challenging. Bones already weakened by complications of Charcot foot could collapse under the patient’s weight.

Dr. Pinzur employs a technique that secures bones with an external frame, made of stainless steel and aircraft-grade aluminum. The device, called an Ilizarov circular external fixator, contains three rings that surround the foot and lower calf. The rings have stainless-steel pins that extend to the foot and secure the bones after surgery.

Following surgery, the device remains on the patient for 10 to 12 weeks. During that time, patients often are able to walk or at least bear some weight. After the fixation device is removed, the patient wears a walking cast for four to six weeks. The patient then progresses to a removable boot and finally to diabetic shoes.

Source:

https://www.loyolamedicine.org/

Tagged with:

About author

Related Articles