Diabetic Foot Flashcards
What makes up nearly 50% of all diabetes-related hospital admissions?
Diabetic foot problems
What is the most common cause of non-traumatic lower limb amputation.
Diabetes
Explain how vascular problems might cause diabetic foot.
Ischaemia from peripheral vascular disease and diabetes compromises the ability to heal after minor trauma or infection.
What are the two types of diabetic foot?
Neuropathic diabetic foot.
Vascular diabetic foot.
Explain neuropathic diabetic foot.
Pain is protective, if it fails the patient won’t experience trauma as much. They might walk on a wounded foot and exacerbate the problem and cause it to never heal.
Autonomic neuropathy also reduces sweating and alters blood flow resulting in dry skin prone to cracks and fissures.
What is charchot arthropathy a complication of?
Severe neuropathy
Three phases of Charcot arthropathy.
It occurs in a well-perfused foot.
1 - Acute onset
2 - Bony destruction
3 - Radiological consolidation and stabilisation
Classical presentation of Charcot arthropathy.
Acutely swollen hot foot.
A third of patients also experience pain.
Differentials of Charcot arthropathy.
Cellulitis (treat for both if unsure)
Acute gout
DVT
Complication of Charcot arthropathy if treatment is delayed.
Foot can be deformed as bone is destroyed rapidly over weeks.
After 6-12 months the destructive process stabilises
Treatment of Charcot arthropathy.
Immobilisation in a non-weight bearing cast. Should be continued until the swelling and temperature of the foot has resolved.
Rehabilitation is always necessary and reconstructive surgery might be needed.
Aim of treatment of Charcot arthropathy.
Prevent or minimise bony destruction and deformity.
What happens if there is deformity of the foot?
Predisposes the foot to future ulcerations due to altered pressure distribution.
Key management of diabetic foot.
Prevention