The Diabetic Charcot Foot: Principles and Management

Robert G. Frykberg, DPM, MPH. Chief, Podiatry, Carl T. Hayden VA Medical Center, Phoenix, Arizona Published by Data Trace Publishing Company P.O. Box 1239 Brooklandville, Maryland 21022-9978 410-494-4994 Fax: 410-494-0515 www.datatrace.com/medical

ISBN 13:

Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editor and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner. The authors, editor, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. The authors and editor have endeavored to locate the copyright owners and to request permission for the use of all copyrighted material reprinted in this book; except for those references deemed to be fair use under the Copyright Act. Portions of material from chapter 20 reprinted from Clinics in Podiatric Medicine and Surgery, Jostel A, Jude EB, 25(1), Medical Treatment of Charcot Neuroostearthropathy, 63-69, 2008, with permission from Elsevier.

Library of Congress Cataloging-in-Publication Data

ii Contributors

David G. Armstrong, DPM, PhD Professor of Surgery, University of Arizona College of Medicine, Tucson Arizona

Chris E. Attinger, MD Director, Wound Healing Center, Professor of Surgery, Department of Plastic Surgery, Georgetown University Medical Center, Washington, District of Columbia

Ronald J. Belczyk, DPM Fellow, Foot and Ankle Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Nicholas J. Bevilacqua, DPM Broadlawns Medical Center, Des Moines, Iowa

Georgeanne Botek, DPM Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio

Andrew J. M. Boulton, MD, DSc (hon), F.R.C.P. Professor of Medicine/Consultant Physician, University of Manchester/ Manchester Royal Infirmary, Manchester, United Kingdom

Frank Bowling, MS, PhD(c) University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom

Melissa Brawner, DPM Private practice, San Antonio, Texas

Carlo Caravaggi, MD Honorary Professor, University Vita Salute San Raffaele, Milano, Italy; Chief of Diabetic Foot Department, Abbiategrasso Hospital, Abbiategrasso, Italy; Chairman, Italian Diabetic Foot Study Group SID-AMD; Vice Chairman, Diabetic Foot Study Group – EASD

Alan R. Catanzariti, DPM Director of Residency Training, Division of Foot and Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, Pennsylvania

Peter Cavanagh, PhD, DSc Professor, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington

Kelly Cheer ST3 in Diabetes and Endocrinology, Tameside Hospital Acute NHS, Ashton-under-Lyne, United Kingdom

iii iv Contributors

Brandon Child, DPM Chief Resident, Division of Foot and Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, Pennsylvania Mark W. Clemens, MD Resident, Department of Plastic Surgery, Georgetown University Medical Center, Washington, District of Columbia Michael Cohen, MD Resident, Department of Plastic Surgery, Georgetown University Medical Center, Washington, District of Columbia Prof. Luca Dalla Paola MD Chief, Diabetic Foot Department, Abano Terme Hospital, Padova, Italy; Institute of Vascular Surgery, Bologna University School of Medicine, Bolonga, Italy

Michael Edmonds, MD Diabetic Foot Clinic, King’s College Hospital, London, United Kingdom

Magnus Eneroth, MD, PhD Associate Professor, Department of Orthopedics, Clinical Sciences, Lund University Hospital, Lund, Sweden

Fran L. Game F.R.C.P., M.R.C.Path. Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, Nottingham University Hospitals Trust, City Hospital Campus, Nottingham, United Kingdom

William J. Jeffcoate, M.R.C.P. Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, Nottingham University Hospitals Trust, City Hospital Campus, Nottingham, United Kingdom

Andreas Jostel, MD Specialist Registrar in Diabetes and Endocrinology, Tameside Hospital Acute NHS, Ashton-under-Lyne, United Kingdom

Edward Jude, MD Consultant Physician and Honorary Senior Lecturer, Tameside Hospital Acute NHS, Ashton-under-Lyne, United Kingdom

Bradley M. Lamm, DPM International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland

Lawrence A. Lavery, DPM, MPH Professor, Department of Surgery, Scott and White Memorial Hospital, Texas A&M Health Science Center College of Medicine, Temple, Texas

J. Patrick Martens, MD Orthopaedic Foot and Ankle Fellow, Cleveland Clinic Foundation, Cleveland, Ohio Contributors v

Robert W. Mendicino, DPM Chief, Division of Foot and Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, Pennsylvania

Stephan Morbach, MD Chief Physician, Department of Diabetes and Angiology, Soest, Germany

William B. Morrison, MD Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Tammy M. Owings, D. Eng. Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio

Dror Paley, MD, F.R.C.S.C. International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland

Nina L. Petrova, MD Diabetic Foot Clinic, King’s College Hospital, London, United Kingdom Judith Pfleegor, PT Director, Diabetes Foot Clinic, Mount Nittany Medical Center, State College, Pennsylvania Michael S. Pinzur, MD Professor of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, Maywood, Illinois Lee C. Rogers, DPM Director, Amputation Prevention Center at Broadlawns Medical Center, Des Moines, Iowa Lee J. Sanders, DPM Chief, Podiatry Service, VA Medical Center, Lebanon, Pennsylvania; Adjunct Clinical Professor, Department of Podiatric Medicine, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania James Sferra, MD Head, Section of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio Conor P. Shortt, MD Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania Amy Y. I. Ting, M.B.B.S. Gold Coast Hospital, Southport, Queensland, Australia Jan S. Ulbrecht, M.B., BS Professor of Biobehavioral Health and Medicine and Co-Director, Penn State Institute for Diabetes and Obesity, Pennsylvania State University, University Park, Pennsylvania vi Contributors

Loretta Vileikyte, MD, PhD Senior Lecturer/Clinical Fellow in Medicine, University of Manchester/ Manchester Royal Infirmary, Manchester, United Kingdom

Jeffrey K. Wu, MD Cleveland Clinic Florida, Department of Orthopaedic Surgery, Section of Foot & Ankle Surgery, Weston, Florida

Dane K. Wukich, MD Chief, Division of Foot and Ankle Surgery, University of Pittsburgh Medical Center Department of Orthopedic Surgery; Assistant Professor, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Medical Director, UPMC Comprehensive Foot and Ankle Center, Pittsburgh, Pennsylvania

Thomas Zgonis, DPM, F.A.C.F.A.S. Associate Professor, Department of Orthopaedics; Chief, Division of Podiatric Medicine & Surgery; Director, Podiatric Surgical Residency & Fellowship Programs, The University of Texas Health Science Center at San Antonio, San Antonio, Texas