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. 2010 Jan;33(1):98-100.
doi: 10.2337/dc09-1497. Epub 2009 Oct 13.

Lower-extremity amputation risk after charcot arthropathy and diabetic foot ulcer

Min-Woong Sohn  1 , Rodney M Stuck, Michael Pinzur, Todd A Lee, Elly Budiman-Mak
Affiliations

Lower-extremity amputation risk after charcot arthropathy and diabetic foot ulcer

Min-Woong Sohn et al. Diabetes Care. 2010 Jan.

Abstract

Objective: To compare risks of lower-extremity amputation between patients with Charcot arthropathy and those with diabetic foot ulcers.

Research design and methods: A retrospective cohort of patients with incident Charcot arthropathy or diabetic foot ulcers in 2003 was followed for 5 years for any major and minor amputations in the lower extremities.

Results: After a mean follow-up of 37 +/- 20 and 43 +/- 18 months, the Charcot and ulcer groups had 4.1 and 4.7 amputations per 100 person-years, respectively. Among patients <65 years old at the end of follow-up, amputation risk relative to patients with Charcot alone was 7 times higher for patients with ulcer alone and 12 times higher for patients with Charcot and ulcer.

Conclusions: Charcot arthropathy by itself does not pose a serious amputation risk, but ulcer complication multiplicatively increases the risk. Early surgical intervention for Charcot patients in the absence of deformity or ulceration may not be advisable.

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