Cases reported "Diabetic Foot"

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1/7. Long-term antibiotic treatment in geriatric diabetic foot infection.

    A case report involving a 77-year old diabetic patient with an arterial foot ulcer and subsequent osteomyelitic infection is presented. Due to the patient's ineligibility for surgical intervention, long term antibiotic treatment based upon multiple culture, bone biopsy, radiograms and isotope scanning was initiated. Complete resolution of the osteomyelitis defined by subjective as well as objective criteria was achieved after three months of antibiotic treatment. The common and atypical characteristics of the geriatric population coupled with treatment plan involving a multidisciplinary approach resulted in maintaining foot function and pain-free ambulation in this 77-year old patient.
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2/7. Neuropathic osteoarthropathy in the diabetic foot.

    OBJECTIVE: To discuss a case involving a 55-year-old diabetic woman with neuropathic osteoarthropathy initiated by a fall. CLINICAL FEATURES: The patient fell into a hole, injuring her left foot. Because of the anesthesia associated with her diabetic peripheral neuropathy, she did not notice the ensuing plantar puncture wound. The patient assumed that her swelling was a result of a sprain. Mild dislocation and osseous fragmentation was noted within the midfoot on radiographs. The neuropathic osteoarthropathy progressed until the patient was later casted. Plain films taken at the time of cast removal demonstrated resorption and consolidation of fragmentation, but the dislocation was unaltered. INTERVENTION AND OUTCOME: The patient was scheduled for surgery and wound debridement. However, before surgery, complications of a burn sustained on the contralateral foot required fifth ray amputation. Surgery of the left foot has been postponed until adequate postsurgical healing has occurred at the right foot amputation site. CONCLUSION: This article provides tools for the timely diagnosis and treatment of neuropathic osteoarthropathy. An increased understanding of this entity will help lead to a reduction in the incidence of delayed treatment resulting from misdiagnosis.
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3/7. diagnostic imaging of the diabetic foot. What the clinician expects to know from the radiologist....

    A case of diabetic foot in a patient with advanced diabetes is presented. The correct diagnostic approach was analyzed based on the reasoned combination of available diagnostic imaging procedures (color-Doppler US, CT-angiography, MR-angiography and digital subtraction angiography) and on the clinician's instances. Angiographic findings contraindicated intravascular treatment. Femorotibial surgical bypass was performed.
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4/7. osteomyelitis in the foot and ankle associated with diabetes mellitus.

    osteomyelitis in a foot or ankle is a common complication in patients with diabetes mellitus. Although acute osteomyelitis can be a surgical emergency, this presentation is uncommon. Chronic bone infection in most patients is associated with either vascular impairment or neuropathic skin breakdown or both. Neuropathic joints and stress fractures have to be differentiated from radiographic abnormalities caused by infection.
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5/7. Reconstruction of the diabetic Charcot foot incorporating bone grafts.

    literature is sparse concerning the topic of Charcot foot reconstruction incorporating various types of bone grafts and internal fixation. No concrete, methodical approach has yet been established to dictate under what conditions bone grafting would be applicable in Charcot joints. It is the intent of the authors to convey, through limited experience, an approach to the surgical reconstruction of the diabetic Charcot foot using bone grafting and internal fixation as it applies to the Sanders and Mrdjenovich patterns 2 and 3. Three case studies are presented with emphasis on the biomechanical examination, computerized tomography, radiographic appearance, patterns of bone and joint destruction, and types of bone grafts using internal fixation.
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6/7. Hypodermic needles in the neuropathic foot of a patient with diabetes.

    A 54-year-old woman with insulin-dependent diabetes mellitus, diabetic neuropathy, neuropathic arthropathy of the feet and a plantar ulcer underwent plain radiography, which showed 2 clipped-off hypodermic needles, of which she had been unaware, in the soft tissue of one foot. This previously unreported complication is clinically instructive in that it demonstrates the importance of counselling patients about the protection of insensitive extremities. This case also has public health implications, suggesting as it does that the still-common practice of breaking hypodermic needles before disposal should be strongly discouraged.
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7/7. Charcot's joint following Keller arthroplasty. A case report.

    Neuropathic osteoarthropathy, i.e., Charcot's joint, has not previously been reported as a sequela of elective foot surgery. The authors present a challenging case of a patient with long-standing diabetes mellitus and peripheral neuropathy who developed neuropathic osteoarthropathy after a Keller arthroplasty for a recalcitrant hallux ulcer. The radiographic findings, diagnostic tests, and histopathology are discussed. Finally, the authors offer suggestions for surgeons contemplating a Keller arthroplasty for patients with peripheral neuropathy.
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