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Diabetische Osteoarthropathie: operative Strategie

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Fortbildung Osteologie

Part of the book series: Fortbildung Osteologie ((FORTOSTEO,volume 3))

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Zusammenfassung

Während die Stadien 0 und I (Eichenholtz-Levine) der diabetisch-neuropathischen Osteoarthropathie (DNOAP) eine Domäne der konservativen Therapie darstellen, können sich ab Stadium II verschiedene Operationsindikationen ergeben. Immer wenn bei schweren, konservativ nicht ausreichend therapierbaren Fehlstellungen oder Instabilitäten von Fuß- und Sprunggelenk rezidivierende Ulzerationen vorliegen oder drohen, ist eine operative Intervention zu überlegen. Neben der Ulkusprophylaxe ist das Ziel eines operativen Eingriffs die innere Druckentlastung sowie die Rekonstruktion und Stabilisierung des Fußskeletts, um eine Schuhversorgung zu ermöglichen und damit die Mobilität des Patienten dauerhaft sicherzustellen [37]. Operative Interventionen sollten möglichst nach Abklingen der akuten Phase durchgeführt werden [26]. Vor einem operativen Eingriff ist stets die Durchblutung des Fußes zu überprüfen. Besteht die Möglichkeit die Perfusion der Extremität zu verbessern, so ist die gefäßchirurgische Intervention einem Knocheneingriff voranzustellen.

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Authors and Affiliations

  1. Orthopädische Klinik München-Harlaching, Zentrum für Fuß- und Sprunggelenkchirurgie, D-81547, München

    Prof. Dr. med. Markus Walther

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  1. Prof. Dr. med. Markus Walther
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© 2010 Springer-Verlag Berlin Heidelberg

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Walther, M. (2010). Diabetische Osteoarthropathie: operative Strategie. In: Fortbildung Osteologie. Fortbildung Osteologie, vol 3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-05385-6_17

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  • DOI: https://doi.org/10.1007/978-3-642-05385-6_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-05384-9

  • Online ISBN: 978-3-642-05385-6

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