Abstract：
Lateral column deterioration and subsequent loss of function poses a challenge for limb preservation in patients with Charcot neuroarthropathy (CN). Application of \"superconstructs\" provides stability and clinical improvement to an often-ulcerated lateral foot. This study examines radiodensity in Hounsfield units (HU) to compare bone quality of lateral column fixation targets using computed tomography (CT) scans between patients with and without midfoot CN. A retrospective chart review identified control (nondiabetic, non-CN; n = 29) and midfoot CN (n = 21) groups. Patient demographics and medical history were collected. Two reviewers measured the mean HU of circular regions of interest centered on the fourth and fifth metatarsal heads as well as the anterior, middle, and posterior thirds of the calcaneus. Radiodensity was compared between groups, among calcaneal locations, Eichenholtz stages and Brodsky types. A p value ≤.05 was considered statistically significant. Age and body mass index were not significantly different between groups. The CN group exhibited greater HU than the control group at the metatarsal head and calcaneus (p < .001). The anterior calcaneus exhibited greater HU than the posterior calcaneus in the CN group (p = .02). The difference in HU was not statistically significant between Stages 0-1 and Stages 2-3 or midfoot Brodsky Types. Indirect bone density analysis revealed an increased density in CN compared to control patients with no significant difference between midfoot CN stages or types. The anterior calcaneus was the densest rearfoot bone among the CN patients, a result that may have implications in surgical fixation.
摘要：
侧柱恶化和随后的功能丧失对Charcot神经关节病（CN）患者的肢体保存提出了挑战。“超结构”的应用为经常溃疡的外侧足提供了稳定性和临床改善。这项研究检查了Hounsfield单位（HU）的放射密度，以比较有和没有中足CN的患者之间使用计算机断层扫描（CT）扫描的侧柱固定目标的骨质量。回顾性图表回顾确定了对照(非糖尿病，非CN；n=29）和中足CN（n=21）组。收集患者的人口统计学和病史。两名评论者测量了以第四和第五跖骨头以及前部为中心的圆形感兴趣区域的平均HU，中间,跟骨的后三分之二。组间比较放射倾向，在跟骨位置中，Eichenholtz阶段和Brodsky类型。p值≤0.05被认为具有统计学意义。两组之间的年龄和体重指数没有显着差异。CN组在跖骨头和跟骨表现出比对照组更大的HU(p<.001)。在CN组中，前跟骨表现出的HU大于后跟骨（p=.02）。在0-1阶段和2-3阶段或中足Brodsky类型之间，HU的差异无统计学意义。间接骨密度分析显示，与对照组患者相比，CN的密度增加，中足CN分期或类型之间无显着差异。前跟骨是CN患者中最致密的后足骨，可能对手术固定有影响的结果。
