[Ortho] Следует ли оперировать?

[Dr. A. Liberson]

Dear Dr Adonin,
I want 2 congratulate you with this excellent citations, I would suggest to
add the natural history and the stages. I would operate on it when it is
cold. The result of the surgery should be stable. Being mainly a foot person
I see those in feet, but I have seen few of the knee and surgery may be
equally difficult especially in early stages regarding Diabetics,
Syphilitics and spinal or lepra etiology. If you do it properly and stable,
I would not regard Diabetics more difficult than others.
Good luck with this difficult case.
AL

-----Original Message-----
From: ortho-bounces на weborto.net [mailto:ortho-bounces на weborto.net] On Behalf
Of Adonin
Sent: Monday, April 05, 2010 8:00 PM
To: ortho на weborto.net
Subject: Re: [Ortho] Следует ли оперировать?

http://emedicine.medscape.com/article/1234293-overview

In 1703, William Musgrave first described a neuropathic joint as an
arthralgia caused by venereal disease.1 In 1868, Jean-Martin Charcot gave
the first detailed description of the neuropathic aspect of this disease;
hence, the condition is named after him.2 Charcot noted this disease process
as a complication of syphilis

Pathophysiology

The exact nature of Charcot arthropathy remains unknown, but the following
major theories exist regarding the pathophysiology of this condition:
Neurotraumatic theory - This theory states that Charcot arthropathy is
caused by an unperceived trauma or injury to an insensate foot. The sensory
neuropathy renders the patient unaware of the osseous destruction that
occurs with ambulation. This microtrauma leads to progressive destruction
and damage to bone and joints.
Neurovascular theory - This theory suggests that the underlying condition
leads to the development of autonomic neuropathy, causing the extremity to
receive an increased blood flow. This in turn results in a mismatch in bone
destruction and synthesis, leading to osteopenia.
Adonin



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