Identification of high-risk groups of charcot foot in the people with diabetic foot neuropathic ulcerations

Abstract

Objective To identify high-risk groups of Charcot foot(CN) in the people with diabetic foot neuropathic ulcerations(NU). Methods Twenty cases patients with CN who were diagnosed in General Hospital of the Chinese People Air Force from June 2008 to June 2013 and 58 patients with diabetic neuropathic ulcer who were hospitalized from January 2010 to December 2011 and followed up until June 2014 without foot deformity were retrospectively analyzed.All patient's general condition, examination and laboratory results, diabetic chronic complications, complication, diabetes distribution of foot ulcers, and plain features. Results There were no statistically significant differences in terms of patients' average age, sex ratio, proportion of smokers, BMI, HbA1c, blood lipid, dorsalis pedis artery diameter and diabetic nephropathy (Ⅲ-Ⅳ period), chronic kidney disease stage 3 above, proliferation diabetic retinal pathological changes, the prevalence of coronary heart disease between the two groups(P>0.05). Compared with NU group, patients with single high proportion(40.00%(8/20) vs.10.34%(6/58)), Short duration of diabetes((12.37±5.64) years vs.(14.27±8.04) years), Feet long numbness(6(5, 9) years vs.4(2, 20) years), low rate of hardening of the arteries narrow(ABI<0.9)( 0(0/20) vs.39.66%(13/58)), high recurrent diabetic foot ulcer prevalence(70.00%(14/20) vs.25.86%(15/58)), more patients with diabetes mellitus autonomic neuropathy(75.00%(15/20) vs.39.66%(23/58)), less combined with hypertension(25.00%(5/20) vs.58.62%(34/58)), the differences were significant(t orχ2=6.981, 2.259, 4.068, 3.887, 12.405, 7.436, 6.724; P<0.05). Diabetic foot wound distribution on mesopodium of CN group and NU group was 36.84%(7/19), 6.90%(4/58) respectively, the difference was significant(χ2=11.443, P=0.003). Diabetic foot amputation rate(Wanger 4, 5 grade) of CN group and NU group was 44.44%(4/9), 6.90%(2/29) respectively, the difference was significant(χ2=4.732, P=0.020). Conclusion The characteristics of high-risk groups of diabetics Charcot foot in the people with diabetic foot neuropathic ulcerations are middle aged, no foot of ischemia, combine the diabetic autonomic neuropathy and the feet always with recurrent ulcers. Key words: Diabetic foot ulcer; Diabetic peripheral neuropathy; Neuropathic ulcer; Charcot foot