[Ortho] Дефартроз голеностопа+перелом пилона+перелом тарана?

[Dr.Gofman]

Здравствуйте
Перед  реконструкцией  сустава  обязательно надо провести диф диагностику, эта проблема на мой взгляд называется Charcot's Joint
(извините что скопировал много по английски ) особенно я  бы подчеренул последнюю фразу о  низком  проценте удачного артродеза
Any condition resulting in decreased peripheral sensation, proprioception, and fine motor control:
∙	Diabetes mellitus neuropathy (the most common in the U.S. today, resulting in destruction of foot and ankle joints), with Charcot joints in 1/600-700 diabetics. Related to long-term poor glucose control. 
∙	Alcoholic neuropathy 
∙	Cerebral palsy 
∙	Leprosy 
∙	Syphilis (tabes dorsalis), caused by the organism Treponema pallidum 
∙	Spinal cord injury 
∙	Myelomeningocele 
∙	Syringomyelia 
∙	Intra-articular steroid injections 
∙	Congenital insensitivity to pain 
∙	Charcot-Marie-Tooth disease

Definition of Charcot's Joint
A chronic, progressive and degenerative disease of one or more joints, characterized by swelling, instability of the joint, hemorrhage, heat, and atrophic and hypertrophic changes in the bone. It is also known as neurogenic arthropathy. 
Description of Charcot's Joint
This disease is the result of a neurologic disorder, diabetic neuropathy, leprosy, congenital absence or the depression of pain sensation. In some cases, early recognition of this disease and prophylactic protection of the joint may prevent further damage.
Because of slow healing, surgical reconstruction is not usually effective.

Dr.Gofman