Year 2016 Vol. 24 No 5




SME "Gomel City Clinical Hospital N3"1,
EE "Gomel State Medical University"2
The Republic of Belarus

Objectives. To study the possibility of the development of the acute phase of Charcot osteoarthropathy in patients with neuroischemic form of diabetic foot syndrome (DFS).
Methods. Medical case-histories of patients (n=39) with the acute phase of diabetic Charcot osteoarthropathy, being treated at Gomel Regional Centre Diabetic Foot in 2011-2015 had been analyzed. Osteoarthropathy diagnostic was based on the results of radiological and histological studies. Neuropathy diagnostic was based on the assessment of reducing the levels of tactile, pain, foot temperature and vibration sensitivity. Macroangiopathy was diagnosed in the absence of pulsations at the level of the ankle joint and foot dorsal artery. In this case, changes in the blood flow in the main arteries were refined according to the result of Doppler ultrasound. In some cases multispiral CT and selective angiography of the lower limbs vessels were used.
Results. In the majority of patients (n=33, 85%) Charcot osteoarthropathy developed against the background of peripheral neuropathy without disturbing the main blood flow in the lower limbs. In 6 patients (15%) an acute phase of Charcot osteoarthropathy developed against the background of the previously diagnosed neuroischemic form of DFS. In this group (n=6) all patients (3 females, 3 males, mean age 65 years and mean duration of diabetes 15.6 years) suffered from diabetes mellitus type 2.
Conclusion. The value of the vascular component in the origin and course of the disease needs to be further studied specifically both to clarify the essence of ongoing pathological changes in the limbs on the affected side and to determine the treatment tactics of this severe disease and its complications. Process of arteriovenous shunting in the tissues of the affected lower limb appears the mechanism could be mediated by the development of bone and joint destruction in DFS.

Keywords: Charcot osteoarthropathy, neuroischemic form, diabetic foot syndrome, arteriovenous shunting, Doppler ultrasound, main blood flow, affected lower limb
p. 465-472 of the original issue
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Address for correspondence:
246000, Republic of Belarus, Gomel, Ilich st., 286,
Gomel City Clinical Hospital 3, department 3 of surgical diseases.
Tel. +375 44 780-19-50
E-mail: Dmitrienko Anatoly Anatolevich
Information about the authors:
Dmitriyenko A.A. Deputy Chief Physician, SME "Gomel City Clinical Hospital N3".
Anichkin V.V. MD, Professor of department N3 of surgical diseases, EE "Gomel State Medical University".
Kurek M.F. PhD, Ass. Professor of department N1 of surgical diseases, EE "Gomel State Medical University".
Makanin A.Y. Head of department N3 of surgical diseases, SME "Gomel City Clinical Hospital 3".
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