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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(04): 397-403
DOI: 10.1055/s-0039-3402460
Artigo de Atualização
Tornozelo e Pé

Pé diabético. Parte 2: Neuroartropatia de Charcot[*]

Article in several languages: português | English
Ricardo Cardenuto Ferreira 
1   Grupo de Cirurgia do Pé e Tornozelo, Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
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Resumo

A neuropatia de Charcot (NC) é uma complicação lamentável e comum de pacientes com diabetes, provavelmente resutlante de uma falta de entendimento adequado dessa condição, que leva ao diagnóstico tardio.A confusão diagnóstica com quadro infeccioso contribui para que o tratamento inicialmente indicado seja equivocado ao prescrever medicação antibiótica ou, eventualmente, drenagem cirúrgica. Não é infrequente que a drenagem inadvertida do suposto abcesso revele que na verdade seu conteúdo é formado apenas de partículas provenientes da destruição osteoarticular. A educação adequada, tanto dos pacientes diabéticos quanto dos médicos responsáveis por prestar atendimento primário a estes pacientes, é fundamental para a correta compreensão das principais características relacionadas ao desenvolvimento da NC. O ortopedista geral é quem, na maioria das vezes, recebe no pronto atendimento os pacientes que se encontram na fase aguda inicial da doença. Por esta razão, esses profissionais devem estar extremamente alertas e serem capazes de identificar os primeiros sinais que permitem diagnosticar precocemente a NC. Em tese, isto possibilitaria reduzir a morbidade desta afecção na medida em que o tratamento adequado venha a ser precocemente instituído.

Palavras-chave

diabetes - pé - artropatia neurogênica/complicações - amputação

* Trabalho desenvolvido no Grupo de Cirurgia do Pé e Tornozelo, Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, SP, Brasil.




Publication History

Received: 28 June 2019

Accepted: 13 September 2019

Article published online:
27 April 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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