Book Review   |    
THE CHARCOT FOOT. A CRITICAL REVIEW AND AN OBSERVATIONAL STUDY OF A GROUP OF 60 PATIENTS. Gerardus J. Onvlee. $35.00, 231 pp. (To obtain a copy of this book, you may contact the author directly at: van Daatselaarhof 44, 3833 HV Leudsen, The Netherlands, or at his e-mail address: gerard.onvlee@wxs.nl.)
David Agoada, D.P.M.
J Bone Joint Surg Am, 1999 Oct 01;81(10):1506-1506
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A patient with diabetes mellitus walks into your office with a chief complaint of a swollen left foot. He has no history of trauma and no major discomfort. His main concern is that his foot no longer fits inside his shoe. A radiograph shows a Lisfranc fracture-dislocation. For the physician who has not dealt with diabetic patients on a daily basis, the idea that a patient with a severe traumatic injury could walk into the office with neither a history of trauma nor pain seems farfetched. As the patient is diabetic, a diagnosis of infection or possibly osteomyelitis seems more realistic. The patient is managed with intravenous administration of antibiotics and perhaps a bone biopsy; an amputation may follow. Non-weight-bearing, use of a cast, and open reduction and internal fixation are not considered as part of the treatment regimen. The Charcot foot is one of the most misdiagnosed and mistreated problems seen in diabetic patients.
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