Diagnosis and treatment of Charcot foot in patients with diabetes mellitus
In recent years, we have seen a significant increase in the number of works devoted to the Charcot foot. The aim was to propose and evaluate the optimal approach to diagnosing and treating Charcot foot in patients with type 2 diabetes. We treated 115 patients with type 2 diabetes and Charcot foot. Patients were separated into two groups: the TCC group (65), where it was administrated the treatment with a total contact cast (TCC) and the ORTHOSIS group, where immobilization with rigid orthoses was carried out. The TCC group showed worse results (p=0.004). In the TCC group, the frequency of recurrence of Charcot arthropathy in the next 2 months after the end of treatment was significantly higher (p=0.04). The frequency of development of Charcot arthropathy on the contralateral limb during treatment or in the coming months after it did not differ significantly between patient groups (p=0.14). X-ray in patients with Charcot foot is ineffective in establishing a clinical diagnosis and choosing treatment tactics. MRI of the foot with or without intravenous contrast should be chosen. Staged conservative treatment of Charcot foot shows a positive effect in 80.9% of observations.