Zusammenfassung
Der Charcotfuß bei diabetischer Neuropathie ist eine Folge vermehrten Knochenabbaus aufgrund neuraler Fehlregulation. Im Verlauf der Erkrankung kommt es zu sehr unterschiedlichen Erscheinungsformen, die in extremen Fehlstellungen, ausgedehnten Wunden und schweren Infektionen bestehen können. Häufig wird die Diagnose verspätet gestellt, und es werden viele unnötige Amputationen vorgenommen. Auf der Grundlage der unterschiedlichen Stadien stellen wir eine differenzierte Klassifikation als Voraussetzung für die Behandlung vor. In den Frühstadien ist mit Entlastung eine Heilung ad integrum zu erreichen. In den mittleren Stadien sind teils durch Schuh- und Orthopädietechnik und teils durch stabilisierende Operationen belastbare Füße zu erreichen. In den Spätstadien können nach Infektionen Defekte verbleiben, mit denen das Gehen möglich ist. Amputationen sind bei sachgerechtem Vorgehen nur selten unumgänglich.
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Kessler, S. et al. (2022). Der Charcotfuß. In: Kessler, S. (eds) Die interdisziplinäre Behandlung des diabetischen Fußes. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63119-5_6
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