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Title: Diabetic Charcot foot - a risk of development and the estimation of effectiveness of the treatment model

Abstract:

Charcot neuroarthropathy is a condition affecting mainly the foot and progressing with bone destruction and an inflammatory process of soft tissues of the foot.The Charcot foot occurs in patients with advanced neuropathy. The etiopathogenesis of the Charcot foot has not been fully explained. To this day, Mitchell and Charcot’s theory and Volkman’s theory have been widely used. Nowadays there are more and more followers of the new theory of bone turnover disorders in Charcot joint, dysregulated OPG/RANKL/RANK axis - the axis that is involved in regulating bone turnover.The aim of the study was to describe patients who are at high risk of developing Charcot joints by determining causative factors and the progression of radiological changes. Also to establish the possibilities of secondary preventive procedures to avoid the Charcot foot. Finally, to evaluate healing after skin grafting and to introduce optimal treatment methods of Charcot joints.Material and methods: The subject of the study were patients treated at the outpatient clinic of the Orthopedics Department CMUJ and the outpatient clinic of the II Chair of Surgery CMUJ between 1995 and 2009. The final analysis included 60 subjects in the 22 - 74 age bracket. In this group, 22 patients with type 1 diabetes, and 38 patients with type 2 diabetes. The shortest observation period for patients was over 12 months. A number of examinations were performed in order to confirm the diagnosis of polyneuropathy: sensation of pressure examination, sensation of pain examination, temperature sensitivity test and vibration perception test. Tendon reflexes were also examined. In all patients radiological and pedobarographic examinations as well as densitometry tests were performed. Conclusions: Charcot joints occur more frequently in type 2 diabetic patients with unsatisfactory blood glucose control and after many years of having the disease. Changes are one-sided and ulcers rarely form at the onset of the disease. Treatment, according to clinical practice recommendations, in 100% convert active process to non-active.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

chirurgia ; endokrynologia

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Leszek Brongel

Date issued:

2012

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:3602

Call number:

ZB-118267

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

Object collections:

Last modified:

Oct 29, 2019

In our library since:

Jul 18, 2013

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6

Number of object content views in PDF format

6

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/3602

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ZB-118267 Oct 29, 2019
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