A 50-year-old woman with type 1 diabetes of 35 years' duration attempted to board a bus and missed her step and fell to the ground. She sustained a spiral fracture of the tibia and was treated conservatively with a below-knee plaster cast (Fig. 3.14a). However she developed Charcot changes at the ankle joint (Fig. 3.14b).
• Diabetic patients with type 1 diabetes have osteopenia and are susceptible to fractures
• Fractures can precipitate Charcot's osteoarthropathy.
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