TOTBİD Dergisi

TOTBİD Dergisi

2013, Cilt 12, Sayı, 5     (Sayfalar: 464-475)

Diabetic foot: pathogenesis, clinical forms and their management, comorbidities

Mehmet Oğuz Durakbaşa 1

1 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2013.55
Görüntüleme: 179
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İndirme : 505

Diabetic foot which begins with diabetic polyneuropathy and appears as clinical forms like diabetic foot ulcer and Charcot osteoarthropathy (CNO) can be complicated by peripheric vascular disease (PVD) or infection and amputation can pursue. The factors that multiply amputation and mortality risks are the comorbidities like end-stage renal failure and cardiovascular disease.

While treating diabetic foot, it should not be forgotten that the main problem is the patient`s impaired glycemic control and metabolism. It is impossible to be successful in orthopaedic management without achieving metabolic homeostasis. Orthopaedic treatment options are educating the patients and their relatives about diabetic foot and about the precautions to prevent it; healing sandal, special footwear, total contact cast and debridement for diabetic foot ulcers; total contact cast and surgical treatment for CNO; antibiotic treatment, emergency surgery and amputation for diabetic foot infection; revascularization procedures for PVD.

Currently, `uncontrolled inflammation` due to impairment of glucose metabolism is emphasized as the pathogenesis of diabetic foot on molecular basis and research is done for new drugs. These new drugs may create new horizons for the treatment of this complication of diabetes that may be promising.

Anahtar Kelimeler : foot with diabetes; pathogenesis; neuropathy; ulcer; Charcot foot; amputation; comorbidity; mortality