The Diabetic Foot by Gregory P. Guyton, and Charles L. Saltzman J Bone Joint Surg Am Volume...

The Diabetic Foot

by Gregory P. Guyton, and Charles L. Saltzman

J Bone Joint Surg AmVolume 83(7):1083-1096

July 1, 2001

©2001 by The Journal of Bone and Joint Surgery, Inc.

Diabetic neuropathy can present in a wide variety of patterns.

Gregory P. Guyton, and Charles L. Saltzman J Bone Joint Surg Am 2001;83:1083-1096


The results of the Diabetes Control and Complications Trial (DCCT) indicated that the percentage of patients in whom abnormalities developed was significantly lower in association with

intensive glucose control, according to the findings of both neurologic ...



Photograph of the foot of a patient with neuropathic claw toes, showing ulcerations over the prominent dorsal aspects of the proximal interphalangeal joints where the toes rubbed against

the shoe.



Figs. 4-A and 4-B A radiograph and clinical photograph of the foot of a patient with a midfoot ulceration from Charcot arthropathy with subsequent collapse.



A patient with diabetic cheiropathy (limited joint mobility) exhibits the “prayer sign.” Subtle contractures at the interphalangeal and metacarpophalangeal joints prevent the fingers from

fully opposing each other.



The hallux of a patient with severe autonomic neuropathy.



A diagram representing a partial explanation of the pathogenesis of microangiopathy.



Diabetic patients with autonomic dysfunction often have engorged vasculature when the foot is dependent (left).



Mönckeberg sclerosis (medial arterial calcification) is readily apparent on radiographs and is strongly associated with autonomic failure and Charcot arthropathy, as it was in this patient.



The Diabetic Foot by Gregory P. Guyton, and Charles L. Saltzman J Bone Joint Surg Am Volume...

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