Abstract
The effect of a palliative radiotherapy (local X‐ray irradiation with a total of 2.45 Gy) over standard treatment was assessed in a placebo‐controlled double blind study in 12 diabetic patients with acute neurogenic osteoarthropathy (Charcot foot). All patients received standard treament as performed in this institution, including absolute pressure relief (bed rest and/or wheel chair) and preventive application of antibiotics (oral cephalexin or clindamycin), and either radiotherapy or sham‐radiotherapy. The time until healing (defined as absence of swelling, redness and hyperthermia during mild to moderate weight‐bearing re‐calcification of previous fractures or osteolyses on the first of two consecutive roentgenogrammes) was recorded as outcome measure.
There was no difference in healing time according to radiotherapy (7 [95% Cl 4–10] months versus 9.7 [4–15] months, p>0.05). However, compliance versus non‐compliance with non‐weight‐bearing was associated with a significant reduction in healing time (5.5[3–7] months versus 10.5[8–20]months, p < 0.05).
In conclusion, non‐weight‐bearing supports healing of acute Charcot feet in diabetes, whereas radiotherapy does not.