Breaking News
December 11, 2018 - Obesity May Be Driving Rise in Uterine Cancers
December 11, 2018 - Antioxidants may prevent cognitive impairment in diabetes
December 11, 2018 - Oral cancer prognostic signature identified
December 11, 2018 - How Can I Find Out What Caused My Miscarriage?
December 11, 2018 - Novel personalized medicine tool for assessing inherited colorectal cancer syndrome risk developed
December 11, 2018 - Study uncovers 11 new genes associated with epilepsy
December 11, 2018 - Filling research gaps could help develop more disability-inclusive workplaces
December 11, 2018 - Cartilage tissue engineering brings good news for patients with cartilage defects
December 11, 2018 - Novel 3D printing workflow helps predict leaky heart valves
December 11, 2018 - Imagination can help overcome fear and anxiety-related disorders, shows study
December 11, 2018 - Are caries linked to political regime?
December 11, 2018 - Leader in Diabetes Clinical Trials Wins Naomi Berrie Award
December 11, 2018 - Scientists discover cellular mechanism that triggers pneumonia in humans
December 11, 2018 - Increasing mental health problems related to drug use in over 55’s
December 11, 2018 - High-intensity interval exercise could help combat cognitive dysfunction in obese people
December 11, 2018 - Annual flu shot can save lives of heart failure patients
December 11, 2018 - Researchers compare health outcomes for VA and non-VA hospitals
December 11, 2018 - Recommendations Developed for Psoriatic Arthritis Treatment
December 11, 2018 - Genetic analysis links obesity with diabetes, coronary artery disease
December 11, 2018 - Study shows that having genetic information can affect how the body responds
December 11, 2018 - UNAIDS Report: 9 Million Are Likely HIV Positive And Don't Know It
December 11, 2018 - Lund University researchers succeed in obtaining dendritic cells by direct reprogramming
December 11, 2018 - Breast tumors recruit bone marrow cells to boost their growth, study reveals
December 11, 2018 - Updated breast cancer screening guideline highlights importance of shared decision-making
December 11, 2018 - EHR-related stress associated with physician burnout
December 11, 2018 - AHA: 12-Year-Old Heart Defect Survivor Inspires NFL Player’s Foundation
December 11, 2018 - Breast cancer patients who take heart drug with trastuzumab have less heart damage
December 11, 2018 - Providing aid to those humans – and animals – affected by the California fires
December 11, 2018 - Even without proof, CBD is finding a niche as a cure-all
December 11, 2018 - Drawing leads to better memory than writing
December 11, 2018 - Researchers report novel findings on plant hormone
December 10, 2018 - A Tale of Two Labels
December 10, 2018 - Triple combination cancer immunotherapy improves outcomes in preclinical melanoma model
December 10, 2018 - A 14-year-old explains what it’s like to get a new heart
December 10, 2018 - Team Players Honored with 2018 Baton Awards
December 10, 2018 - Global report highlights how the changing world is affecting children’s physical activity levels
December 10, 2018 - Genes play a role in physical activity and sleep
December 10, 2018 - DDT in Alaskan fish shown to increase risk of cancer
December 10, 2018 - Laws to curb use of cell phones have greatly reduced fatalities for motorcyclists
December 10, 2018 - Argenx Provides Detailed Data from Phase 2 Clinical Trial of Efgartigimod in Immune Thrombocytopenia and Phase 1/2 Clinical Trial of Cusatuzumab in Acute Myeloid Leukemia
December 10, 2018 - University of Maryland doctors treat first breast cancer patients with GammaPod radiotherapy
December 10, 2018 - The heartbeat seat: Demoing new well-being technologies in a car
December 10, 2018 - Leading Cancer Researcher to Direct Herbert Irving Comprehensive Cancer Center
December 10, 2018 - Researchers explore how glial cells develop in the brain from neural precursor cells
December 10, 2018 - Study compares pain-related diagnoses in First Nations and non-First Nations children, youth
December 10, 2018 - Experts address sleep disorders following traumatic brain injury
December 10, 2018 - Scientists find answers to how cancer spreads
December 10, 2018 - Study explores why older people read more slowly
December 10, 2018 - Smart life-collar could save lives of young children
December 10, 2018 - Asbestos found in most NHS hospitals finds BBC inquiry
December 10, 2018 - Researchers use new technique to probe hydrogen bonds
December 10, 2018 - Music improves social communication in autistic children
December 10, 2018 - Some Brain Tumors May Respond to Immunotherapy, New Study Suggests
December 10, 2018 - Banning junk food ads to combat childhood obesity
December 10, 2018 - Skin Autofluorescence Predicts T2DM, Heart Disease, Mortality
December 10, 2018 - Largest autism sequencing study to date yields 102 genes associated with ASD
December 10, 2018 - Statins associated with low risk of side effects
December 10, 2018 - Episodic memory tests help in predicting brain atrophy and Alzheimer’s disease
December 10, 2018 - Study explores how schools address adolescent self-harming practices
December 10, 2018 - Pregnancy in adolescence linked to increased risks of complications in young mothers
December 10, 2018 - Risk Analysis publishes special issue on communicating about Zika virus
December 10, 2018 - Botox May Help Prevent Post-Op A-Fib
December 10, 2018 - African-American mothers rate boys higher for ADHD
December 10, 2018 - Graphic warning labels cancel out cigarettes’ appeal to young people
December 10, 2018 - Australian researchers to study gas inhalational anaesthetic and likelihood of cancer return
December 10, 2018 - Individual neurons located within the brain have implications for psychiatric diseases
December 10, 2018 - Researchers improve bariatric surgery scoring system to extend prediction time for diabetic remission
December 10, 2018 - HPV type 16 or 18 associated with cervical cancer risk in young women
December 10, 2018 - Cervical cancer risk is higher in women with positive HPV, but no cellular abnormalities
December 10, 2018 - Combo therapy not needed if low RA disease activity achieved
December 10, 2018 - Novel therapeutic targets based on biology of aging show promise for Alzheimer’s disease
December 10, 2018 - UC San Diego professor receives NCI Outstanding Investigator Award for cancer research
December 10, 2018 - Study evaluates placental mesenchymal stem cell sheets for myocardial repair and regeneration
December 10, 2018 - Blueprint Medicines Announces Updated Results from Ongoing EXPLORER Clinical Trial of Avapritinib Demonstrating Broad Clinical Activity and Significant Symptom Reductions in Patients with Systemic Mastocytosis
December 10, 2018 - Study clarifies ApoE4’s role in dementia
December 10, 2018 - Eating disorders now a top priority with Australian Government
December 10, 2018 - Neuronal activity in the brain allows prediction of risky or safe decisions
December 10, 2018 - FDA Alerts Health Care Professionals and Patients Not to Use Drug Products Intended to be Sterile from Promise Pharmacy
December 10, 2018 - Improving dementia care and treatment saves thousands of pounds in care homes
December 10, 2018 - Heroin-assisted treatment can offer benefits, reduce harms
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