Role of neuropathy on fracture healing in Charcot neuro-osteoarthropathy

G. Mabilleau (1), M.E. Edmonds (2)

(1) Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford;
(2) Diabetic Foot Clinic, King’s College Hospital, London, UK

Abstract
Charcot neuro-osteoarthropathy (CNO) is a devastating condition affecting most commonly the foot/ankle joint in diabetic patients and may lead to severe deformities and amputation. Peripheral sensory neuropathy seems to be a pre-requisite to the development of CNO. The aim of this review article is to summarise the skeletal effects of the nervous system on bone remodelling and fracture healing of normal and damaged joints and to describe how neuropathy, in the context of modern concept of neuroosteopathology, is crucial in the predisposition of the patient to develop acute CNO.

Keywords: Charcot Neuro-osteoarthropathy, Diabetes, Nerve Fibres, Osteoclasts, Bone Resorption