King Abdulaziz University Hospital, Saudi Arabia
Title: Evaluation of charcot neuroarthropathy in diabetic foot disease patients at tertiary hospital
Biography: Ahmed M A Kensarah
Aim: The aim is to evaluate foot Charcot's neuroarthropathy in diabetics in at tertiary hospitals in Jeddah (KSA). The study is a retrospective one, completed at the Surgical Department of King Abdulaziz University Hospital from 2005 – 2015 inclusive (64 patients in 11 years, mean age 61.75 years with male/female ratio 4:1.). The study items were: patient demography, exact presenting symptoms, duration, type of diabetes present, presence of a history of trauma, deformity, ulcer, peripheral vascular disease, obesity, hypertension, and history of previous surgery. Decumented had also been the exact site of involvement (mid, hind or fore-foot) and any given treatment.
Results: Pain was reported in 25%, numbness 12.5%, deformity 23.4%, discharge 73.4%, and difficulty in walking in 12.5%.. Eleven percent of patients reported a history of trauma. Majority of patients (68.8 %) had their diabetes of the no-ninsulin dependent type lasting > 10 years. It was fully controlled in 21.9%.
Other Findings: Nephropathy 46.3%, neuropathy 59.4%, retinopathy 40.6%, cardiomyopathy 48.4% and vasculopathy in 56.3% of cases. Charcot arthropathy involved forefoot in 65.5%, midfoot 4.7% and hindfoot/ankle in 21.9% of cases. Insult present as proven by x-ray as: subluxation 40.6%, dislocation 54.7%, disorganization 42.2%, bone resorption 23.4%, osteomyelitis 14.1%, fractures 50%, and in 39.1%. Three quarters of patients required some sort of amputation, while debridement was sufficient for the rest.
Conclusions: Charcot joint in the feet of diabetics poses great challenge in management. Emphasis should be given for early detection and prompt treatment, to be tailored according to the lesion.