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Nerve abnormalities cause foot disorders.

Neuropathy, or nerve abnormality, is the main problem in diabetics' feet, not poor circulation--a common misconception. Charcot joint or Charcot foot, a disorder in which the joint or foot fractures or dislocates as a result of this nerve abnormality, was considered a rarity until a few years ago. However, there has been growing recognition of the disorder and an increase as the number of diabetics --now about 14,000,000--continues to escalate.

"The effect of Charcot joints is one of sudden, dramatic collapse in the extremities, occurring even without injury, and at times causing complete dislocation of the foot from the end of the leg," explains James W. Brodsky, assistant clinical professor of orthopedic surgery, University of Texas Southwestern Medical School.

"Orthopedists are now making great strides in reconstructing these deformities. The first step in managing the condition is early recognition. Most patients can then be treated with nonsurgical means. During the last century, researchers have postulated that these fractures are the result of repetitive or cumulative microtrauma that occurs due to the inability of the diabetic patients to feel their feet due to lack of sensitivity or |feedback.'

"It is likely that this condition is caused by a combination of both direct effect on the autonomic nerves themselves and the effect of the unperceived trauma. Most of the time, our patients come to see us because something hurts. Diabetic foot problems are unique because they are the one condition in which patients should come to see us, but often don't, precisely because they can't feel pain. Pain is a protective mechanism, and when neuropathy prevents pain, the result can be disastrous." He warns that Charcot joints can produce massive and permanent deformity in some diabetics virtually overnight.
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Title Annotation:diabetes
Publication:USA Today (Magazine)
Date:Feb 1, 1993
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