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Classification of the Charcot neuroosteoarthropathy: evolution of views and unsolved problems

https://doi.org/10.14341/DM13118

Abstract

Diabetic Charcot neuroosteoarthropathy is a manifestation of diabetic foot syndrome, accompanied by a high risk of foot ulcers and amputation. Many aspects of this pathology due to its features remain poorly understood, which leads to difficulties in determining the tactics of treatment of these patients. This review analyzes of anatomical and functional classifications of Charcot foot. The review focuses on the midfoot pathology as the most severe in their consequences. The advantages and disadvantages of different approaches to the description of the X-ray picture of the disease at its various stages are analyzed. The systematization of the literature allows us to conclude that the existing approaches to classification are relatively acceptable mainly when planning conservative treatment. At the same time, detailed anatomical and radiological classifications do not help in choosing the tactics of reconstructive surgical treatment. With the increasing availability of reconstructive surgery for severe deformities due to Charcot’s arthropathy, it seems appropriate to develop classification systems that could become a practical tool for determining surgical tactics in this pathology.

About the Authors

V. B. Bregovskiy
St-Petersburg City diabetes Centre
Russian Federation

Vadim B. Bregovskiy - MD, PhD.

10D Sikeyros str., 194354, St-Petersburg


Competing Interests:

no conflict of interest



S. A. Osnach
Sergey Yudin City Hospital
Russian Federation

Stanislav A. Osnach - MD.

Moscow


Competing Interests:

no coflict of interests



V. N. Obolenskiy
Clinical hospital №13; Pirogov Russian National Research Medical University
Russian Federation

Vladimir N. Obolenskiy - MD, PhD.

Moscow


Competing Interests:

no conflict of interest



A. G. Demina
St-Petersburg City diabetes Centre
Russian Federation

Anastasia G. Demina - MD, PhD.


Competing Interests:

no conflict interest



A. L. Rybinskaya
Consultative and Diagnostic Center of the GS of the RF Armed Forces
Russian Federation

Anastasia L. Rybinskaya - MD.

Moscow


Competing Interests:

no conflict of interest



V. G. Protsko
Sergey Yudin City Hospital; RUDN University
Russian Federation

Victor G. Protsko - MD, PhD.

Moscow


Competing Interests:

no conflict of interest



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Supplementary files

1. Figure 1. Charcot foot classification in leprosy patients (according to Harris JR, Brand PW., 1966) [2].
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Type Материалы исследования
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2. Figure 3. Brodsky J.W. classification modified by Trepmann E. et al. (2005) [9].
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Type Материалы исследования
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3. Figure 2. Classification of midfoot deformities according to Brodsky [7].
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Type Исследовательские инструменты
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4. Figure 4. Classification of midfoot deformities by G. Sammarco, S. Conti [10].
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Type Исследовательские инструменты
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5. Figure 5. Classification of midfoot deformities in diabetic neuroosteoarthropathy by Shon L. et al. [11].
Subject
Type Материалы исследования
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Review

For citations:


Bregovskiy V.B., Osnach S.A., Obolenskiy V.N., Demina A.G., Rybinskaya A.L., Protsko V.G. Classification of the Charcot neuroosteoarthropathy: evolution of views and unsolved problems. Diabetes mellitus. 2024;27(4):384-394. (In Russ.) https://doi.org/10.14341/DM13118

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ISSN 2072-0351 (Print)
ISSN 2072-0378 (Online)