Neuropathic Fracture

Abstract

NEUROPATHIC bone and joint disease has been described in diabetes mellitus complicated by neuropathy, as well as in neurosyphilis, syringomyelia, congenital absence of pain, leprosy, congenital and acquired spinal cord lesions, and following peripheral nerve damage and intra-articular hydrocortisone injections.¹In diabetes, the changes usually seen are those of painless destruction of the tarsal joints, and occasionally of the ankles and knees. When found, they are usually present in association with other neurological features that have received the name of pseudotabes: Argyll-Robertson pupils, postural hypotension, nocturnal diarrhea, gastric atony, bladder dysfunction, pilomotor and sudomotor deficiencies, impotence, and edema. In addition, retinopathy and nephropathy are commonly present, completing the "triopathy" associated with long-standing diabetes mellitus. The present case report deals with a fracture of the tibia and fibula in a diabetic patient possessing many manifestations of pseudotabes and "triopathy." The history and nature of the fracture indicate that it was of