Skip to main content
SpringerLink
Log in

Der Charcot-Fuß

  • Chapter
Das diabetische Fußsyndrom – Über die Entität zur Therapie

  • 1628 Accesses

Zusammenfassung

Teile der Pathogenese des Charcot-Fußes werden noch über 120 Jahre nach dem Tod von Jean-Martin Charcot kontrovers diskutiert und sind über das Stadium der Hypothese nicht hinausgekommen. Zusammenfassend basiert die Diagnostik insbesondere auf Klinik und MRT, die Therapie auf der Ruhigstellung. Chirurgische Verfahren können ergänzend eingesetzt werden. Der Stand der Diskussion über die Pathogenese sowie die aktuelle Entwicklung von Diagnostik und Therapie werden zusammenfassend dargestellt, eine neue Einteilung der natürlichen Geschichte wird eingeführt. Zusammenfassend ist von zentraler Bedeutung, den Verdacht auf einen Charcot-Fuß als Notfall einzustufen, da die frühzeitige Unterbrechung des Zerstörungsprozesses durch unverzügliche Einleitung einer angemessenen Therapie die Funktionsbeeinträchtigung bis hin zum Funktionsverlust des Beins zu verhindern vermag. Sollte die Diagnosesicherung nicht unverzüglich möglich sein, darf dies nicht zum Hinauszögern des Therapiebeginns führen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

Literaturempfehlungen

  • Frykberg RG (Hrsg) (2009) The Diabetic Charcot Foot: Principles and Management, 1. Aufl., 294 Seiten, ISBN-13: 978-1-57400-130-3. Kommentar: umfassender Text mit Einzelkapiteln zahlreicher amerikanischer und europäischer Autoren, der von der Pathogenese über den natürlichen Verlauf bis zum (konservativen und operativen) Management alle relevanten Aspekte des diabetischen Charcot- Fußes adressiert - erste internationale Buchpublikation, die sich exklusiv diesem Thema widmet.

    Google Scholar 

Zitierte Literatur

  • Aragon-Sanchez J, Lazaro-Martinez JL, Hernandez-Herrero MJ (2010) Triggering mechanisms of neuroarthropathy following conservative surgery for osteomyelitis. Diabet Med 27(7):844–847. doi:10.1111/j.1464-5491.2010.03019.x

    Article  CAS  PubMed  Google Scholar 

  • Armstrong DG, Lavery LA (1997) Monitoring healing of acute Charcot's arthropathy with infrared dermal thermometry. JRehabil Res Dev 34(3):317–321

    Google Scholar 

  • Armstrong DG, Lavery LA, Liswood PJ, Todd WF, Tredwell JA (1997a) Infrared dermal thermometry for the high-risk diabetic foot. Physical Therapy 77(2):169–175; disc. 176–167

    Google Scholar 

  • Armstrong DG, Todd WF, Lavery LA, Harkless LB, Bushman TR (1997b) The natural history of acute Charcot's arthropathy in a diabetic foot specialty clinic. Diabet Med 14(5):357–363. doi:10.1002/(SICI)1096-9136(199705)14:5<357::AID-DIA341>3.0.CO;2-8

    Google Scholar 

  • Baker N, Green A, Krishnan S, Rayman G (2007) Microvascular and C-fiber function in diabetic charcot neuroarthropathy and diabetic peripheral neuropathy. Diabetes Care 30(12):3077–3079. doi:10.2337/dc07-1163

    Article  PubMed  Google Scholar 

  • Baumgartner R, Möller M, Stinus H (2013) Orthopädieschuhtechnik, 2. Aufl. C. Maurer Druck und Verlag GmbH & Co. KG, Geislingen/Steige

    Google Scholar 

  • Berendt AR, Lipsky B (2004) Is this bone infected or not? Differentiating neuro-osteoarthropathy from osteomyelitis in the diabetic foot. Curr Diab Rep 4(6):424–429

    Article  PubMed  Google Scholar 

  • Caputo GM, Ulbrecht J, Cavanagh PR, Juliano P (1998) The Charcot foot in diabetes: six key points. Am Fam Physician 57(11):2705–2710

    CAS  PubMed  Google Scholar 

  • Chantelau E, Onvlee GJ (2006) Charcot foot in diabetes: farewell to the neurotrophic theory. Horm Metab Res 38(6):361–367. doi:10.1055/s-2006-944525

    Article  CAS  PubMed  Google Scholar 

  • Chantelau EA, Grutzner G (2014) Is the Eichenholtz classification still valid for the diabetic Charcot foot? Swiss Med Wkly 144:w13948. doi:10.4414/smw.2014.13948

    PubMed  Google Scholar 

  • Christensen TM, Simonsen L, Holstein PE, Svendsen OL, Bulow J (2011) Sympathetic neuropathy in diabetes mellitus patients does not elicit Charcot osteoarthropathy. J Diabetes Complications 25(5):320–324. doi:10.1016/j.jdiacomp.2011.06.006

    Article  PubMed  Google Scholar 

  • Christensen TM, Gade-Rasmussen B, Pedersen LW, Hommel E, Holstein PE, Svendsen OL (2012) Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker. J Diabetes Complications 26(5):430–434. doi:10.1016/j. jdiacomp.2012.05.006

    Article  PubMed  Google Scholar 

  • Colen LB, Kim CJ, Grant WP, Yeh JT, Hind B (2013) Achilles tendon lengthening: friend or foe in the diabetic foot? Plastic and reconstructive surgery 131(1):37e-43e. doi:10.1097/PRS.0b013e3182729e0b

    Google Scholar 

  • Duncan CP, Shim SS (1977) J. Edouard Samson Address: the autonomic nerve supply of bone. An experimental study of the intraosseous adrenergic nervi vasorum in the rabbit. J Bone Joint Surg Br 59(3):323–330

    CAS  PubMed  Google Scholar 

  • Edelman SV, Kosofsky EM, Paul RA, Kozak GP (1987) Neuroosteoarthropathy (Charcot's joint) in diabetes mellitus following revascularization surgery. Three case reports and a review of the literature. Arch Intern Med 147(8):1504–1508

    Article  CAS  PubMed  Google Scholar 

  • Edmonds ME, Roberts VC, Watkins PJ (1982) Blood flow in the diabetic neuropathic foot. Diabetologia 22(1):9–15

    Article  CAS  PubMed  Google Scholar 

  • Eichenholtz SN (1966) Charcot joints. Charles C Thomas, Springfield, IL, S 3–8

    Google Scholar 

  • Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, Landsman AS, Lavery LA, Moore JC, Schuberth JM, Wukich DK, Andersen C, Vanore JV (2006) Diabetic foot disorders. A clinical practice guideline (2006 revision). J Foot Ankle Surg 45(5 Suppl):S1–66. doi:10.1016/s1067- 2516(07)60001–5

    Google Scholar 

  • Game FL, Catlow R, Jones GR, Edmonds ME, Jude EB, Rayman G, Jeffcoate WJ (2012) Audit of acute Charcot's disease in the UK: the CDUK study. Diabetologia 55(1):32–35. doi:10.1007/s00125-011-2354-7

    Article  CAS  PubMed  Google Scholar 

  • Herneth AM, Friedrich K, Weidekamm C, Schibany N, Krestan C, Czerny C, Kainberger F (2005) Diffusion weighted imaging of bone marrow pathologies. Eur J Radiol 55(1):74–83. doi:10.1016/j.ejrad.2005.03.031

    Article  PubMed  Google Scholar 

  • Hoche G, Sanders LJ (1992) On some arthropathies apparently related to a lesion of the brain or spinal cord, by Dr J.-M. Charcot. January 1868. J Am Podiatr Med Assoc 82(8):403–411

    Article  CAS  PubMed  Google Scholar 

  • Jeffcoate WJ, Game F, Cavanagh PR (2005) The role of proinflammatory cytokines in the cause of neuropathic osteoarthropathy (acute Charcot foot) in diabetes. The Lancet 366(9502):2058–2061. doi:10.1016/s0140-6736(05)67029-8

    Article  CAS  Google Scholar 

  • Kiuru MJ, Pihlajamaki HK, Ahovuo JA (2004) Bone stress injuries. Acta Radiol 45(3):317–326

    Article  CAS  PubMed  Google Scholar 

  • Koller A, Springfeld R, Engels G, Fiedler R, Orthner E, Schrinner S, Sikorski A (2011) German-Austrian consensus on operative treatment of Charcot neuroarthropathy: a Perspective by the Charcot task force of the German Association for Foot Surgery. Diabet Foot Ankle 2. doi:10.3402/dfa. v2i0.10207

    Google Scholar 

  • Lowery NJ, Woods JB, Armstrong DG, Wukich DK (2012) Surgical management of Charcot neuroarthropathy of the foot and ankle: a systematic review. Foot Ankle Int 33(2):113–121. doi:10.3113/FAI.2012.0113

    Article  PubMed  Google Scholar 

  • McGill M, Molyneaux L, Bolton T, Ioannou K, Uren R, Yue DK (2000) Response of Charcot's arthropathy to contact casting: assessment by quantitative techniques. Diabetologia 43(4):481–484. doi:10.1007/s001250051332

    Article  CAS  PubMed  Google Scholar 

  • Morrison WB, Ledermann HP, Schweitzer ME (2001) MR imaging of the diabetic foot. Magn Reson Imaging Clin N Am 9(3):603–613, xi

    CAS  PubMed  Google Scholar 

  • Mueller MJ, Sinacore DR, Hastings MK, Strube MJ, Johnson JE (2003) Effect of Achilles tendon lengthening on neuropathic plantar ulcers. A randomized clinical trial. J Bone Joint Surg Am 85-A(8):1436–1445

    PubMed  Google Scholar 

  • Pakarinen TK, Laine HJ, Maenpaa H, Mattila P, Lahtela J (2009) Long-term outcome and quality of life in patients with Charcot foot. J Foot Ankle Surg 15(4):187–191. doi:10.1016/j.fas.2009.02.005

    Article  Google Scholar 

  • Palena LM, Brocco E, Ninkovic S, Volpe A, Manzi M (2013) Ischemic Charcot foot: different disease with different treatment? J Cardiovasc Surg 54(5):561–566

    CAS  Google Scholar 

  • Palestro CJ, Mehta HH, Patel M, Freeman SJ, Harrington WN, Tomas MB, Marwin SE (1998) Marrow versus infection in the Charcot joint: indium-111 leukocyte and technetium- 99m sulfur colloid scintigraphy. J Nucl Med 39(2):346–350

    CAS  PubMed  Google Scholar 

  • Petrova NL, Edmonds ME (2008) Charcot neuro-osteoarthropathy- current standards. Diabet Metab Res Rev 24(Suppl 1):S58–S61. doi:10.1002/dmrr.846

    Article  Google Scholar 

  • Petrova NL, Foster AV, Edmonds ME (2004) Difference in presentation of charcot osteoarthropathy in type 1 compared with type 2 diabetes. Diabetes Care 27(5):1235–1236

    Article  PubMed  Google Scholar 

  • Petrova NL, Moniz C, Elias DA, Buxton-Thomas M, Bates M, Edmonds ME (2007) Is there a systemic inflammatory response in the acute charcot foot? Diabetes Care 30(4):997–998. doi:10.2337/dc06-2168

    Article  PubMed  Google Scholar 

  • Rogers LC, Frykberg RG, Armstrong DG, Boulton AJ, Edmonds M, Van GH, Hartemann A, Game F, Jeffcoate W, Jirkovska A, Jude E, Morbach S, Morrison WB, Pinzur M, Pitocco D, Sanders L, Wukich DK, Uccioli L (2011) The Charcot foot in diabetes. Diabetes Care 34(9):2123–2129. doi:10.2337/ dc11–0844

    Google Scholar 

  • Sanders LJ (2004) The Charcot foot: historical perspective 1827-2003. Diabet Metab Res Rev 20(Suppl 1):S4–S8. doi:10.1002/dmrr.451

    Article  Google Scholar 

  • Sinha S, Munichoodappa CS, Kozak GP (1972) Neuro-arthropathy (Charcot joints) in diabetes mellitus (clinical study of 101 cases). Medicine (Baltimore) 51(3):191–210

    Article  CAS  Google Scholar 

  • Sohn MW, Stuck RM, Pinzur M, Lee TA, Budiman-Mak E (2010) Lower-extremity amputation risk after charcot arthropathy and diabetic foot ulcer. Diabetes Care 33(1):98–100. doi:10.2337/dc09-1497

    Article  PubMed  PubMed Central  Google Scholar 

  • Stuck RM, Sohn MW, Budiman-Mak E, Lee TA, Weiss KB (2008) Charcot arthropathy risk elevation in the obese diabetic population. Am J Med 121(11):1008–1114. doi:10.1016/ j.amjmed.2008.06.038

    Article  PubMed  Google Scholar 

  • Tan AL, Greenstein A, Jarrett SJ, McGonagle D (2005) Acute neuropathic joint disease: a medical emergency? Diabetes Care 28(12):296 2–2964

    Google Scholar 

  • Wienemann T, Chantelau EA, Richter A (2012) Pressure pain perception at the injured foot: the impact of diabetic neuropathy. J Musculoskelet Neuronal Interact 12(4):254–261

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centrum für Diabetologie Endoskopie und Wundheilung, Köln, Germany

    Dr. Dirk Hochlenert

  2. Chirurgische Praxis am Bayenthalgürtel, Köln, Germany

    Gerald Engels

  3. Marienkrankenhaus Soest, Soest, Germany

    Dr. Stephan Morbach

Authors
  1. Dr. Dirk Hochlenert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gerald Engels
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dr. Stephan Morbach
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hochlenert, D., Engels, G., Morbach, S. (2014). Der Charcot-Fuß. In: Das diabetische Fußsyndrom – Über die Entität zur Therapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43944-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-43944-9_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-43943-2

  • Online ISBN: 978-3-662-43944-9

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation