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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2004 March;28(1):13-20
Charcot's neuropathic arthropathy, which manifests at the foot particularly in diabetic patients, although it is also involved in other conditions (tabes, leprosy, syringomyelia, etc.) is examined. Owing to the absence of pain the patient is practically autonomous, thus favouring the onset of serious deformities consequent on neurotrophic skeletal lesions (central and peripheral osteoclastic bone reabsorption or by alisteresis, stress fractures) with often associated attempts at anarchic neosteogenesis (periostal thickening, exuberant osteophytosis). Also on a neurotrophic basis there is an onset of plantar ulcers in overload areas linked to deformities. A neurotrophic and mechanical mechanism therefore intervenes pathogenetically, very often one on top of the other. Apart from the disease (diabetes, lues, etc.) treatment is based essentially on discharge pending possible stabilisation of the lesion. Of uncertain significance infiltrations or lumbar sympathicectomy; in diabetics there is the problem of revascularisation.