2019, Number 3
Orthopedic exploration of the foot and ankle in a patient with diabetes
Gallegos de la TO
Full text
Language: Spanish
References: 4
Page: 153-158
PDF size: 89.76 Kb.
ABSTRACT
An adequate exploration of the foot in diabetic patients is indispensable to obtain a correct diagnosis and/or predictive prognosis of ulceration or diabetic foot itself. The patient should be completely uncovered from the knee down. The scan will be performed in two phases: 1) Patient standing to identify symmetry, alignment, gross deformities, bearing capacity, gait pattern and balance or proprioception; and 2) Patient at rest which will allow palpation of key anatomical points; look at the sole of the foot for hyperkeratosis, contractures, skin lesions or ulcers, as well as checking active and passive ranges of motion of all foot and ankle joints; and finally in this position specific tests can be performed to assess vascular function (such as ankle-arm pressure index), and nerve function (with 10 g Semmes-Weinstein Monofilament test). A foot with no neuropathy and pulses present is considered low risk for ulcers and diabetic foot; if you have neuropathy and pulses present with structural deformity or another cardiovascular risk factor you will be classified as a patient at moderate risk; and if you have neuropathy or absent pulses together with deformities, skin changes or previous ulcer, you will be considered as high risk recommending frequent check-ups by a specialist.REFERENCES