Midfoot Arthrodesis for Charcot Foot Deformity

2017 ◽  
pp. 101-116
Author(s):  
Vincent James Sammarco
Keyword(s):  
Charcot Foot ◽  
Foot Deformity

Neuropathic ulcerations plantar to the lateral column in patients with charcot foot deformity: A flexible approach to limb salvage

1997 ◽  
Vol 36 (5) ◽  
pp. 360-363 ◽  
Author(s):  
Barry I. Rosenblum ◽  
John M. Giurini ◽  
Leonard B. Miller ◽  
James S. Chrzan ◽  
Geoffrey M. Habershaw
Keyword(s):  
Limb Salvage ◽  
Charcot Foot ◽  
Foot Deformity ◽  
Flexible Approach ◽  
Lateral Column

The Development of a Neuropathic Ankle following Successful Correction of Non-Plantigrade Charcot Foot Deformity

2012 ◽  
Vol 33 (8) ◽  
pp. 644-646 ◽  
Author(s):  
Michael S. Pinzur
Keyword(s):  
External Fixator ◽  
Weight Bearing ◽  
Case Series ◽  
Disease Process ◽  
Circular Ring ◽  
Surgical Correction ◽  
Charcot Foot ◽  
Foot Deformity ◽  
Retrospective Case ◽  
Level Of Evidence

Background: The treatment of Charcot foot arthropathy has traditionally involved immobilization during the acute phase followed by longitudinal management with accommodative bracing. In response to the perceived poor outcomes associated with nonoperative accommodative treatment, many experts now advise surgical correction of the deformity, especially when the affected foot is not clinically plantigrade. The significant rate of surgical and medical-associated morbidity accompanying this form of treatment has led surgeons to look for improved methods of surgical stabilization, including the use of the circular ring external fixation. Methods: Over a 7-year period, a single surgeon performed surgical correction of non-plantigrade Charcot foot deformity on 171 feet in 164 patients with a statically applied circular external fixator. Following successful correction, five patients developed a neuropathic deformity of the ipsilateral ankle after removal of the external fixator and subsequent weight bearing total contact cast. Results: Three of the five patients progressed to successful healing of the neuropathic (Charcot) ankle arthropathy following treatment with a series of weightbearing total contact casts. Two underwent successful ankle fusion with retrograde locked intramedullary nailing. Discussion: This unusual clinical scenario likely represents either a progression of the disease process in the foot or a complication associated with surgical correction of the original neuropathic foot deformity. A better understanding of this observation will likely become apparent as we acquire more experience with this disorder. Level of Evidence: IV, Retrospective Case Series

Start treatment early to avoid Charcot foot deformity

BMJ ◽  
2012 ◽  
Vol 344 (may01 2) ◽  
pp. e2765-e2765 ◽  
Author(s):  
E. A. Chantelau
Keyword(s):  
Charcot Foot ◽  
Foot Deformity

Two-stage reconstruction of infected Charcot foot using internal fixation

2021 ◽  
Vol 103-B (10) ◽  
pp. 1611-1618
Author(s):  
Venu Kavarthapu ◽  
Basil Budair
Keyword(s):  
Internal Fixation ◽  
Limb Salvage ◽  
Care Plan ◽  
Surgical Reconstruction ◽  
Charcot Foot ◽  
Foot Deformity ◽  
Two Stage ◽  
Infected Nonunion ◽  
Hardware Failure

Aims In our unit, we adopt a two-stage surgical reconstruction approach using internal fixation for the management of infected Charcot foot deformity. We evaluate our experience with this functional limb salvage method. Methods We conducted a retrospective analysis of prospectively collected data of all patients with infected Charcot foot deformity who underwent two-stage reconstruction with internal fixation between July 2011 and November 2019, with a minimum of 12 months’ follow-up. Results We identified 23 feet in 22 patients with a mean age of 56.7 years (33 to 70). The mean postoperative follow-up period was 44.7 months (14 to 99). Limb salvage was achieved in all patients. At one-year follow-up, all ulcers have healed and independent full weightbearing mobilization was achieved in all but one patient. Seven patients developed new mechanical skin breakdown; all went on to heal following further interventions. Fusion of the hindfoot was achieved in 15 of 18 feet (83.3%). Midfoot fusion was achieved in nine of 15 patients (60%) and six had stable and painless fibrous nonunion. Hardware failure occurred in five feet, all with broken dorsomedial locking plate. Six patients required further surgery, two underwent revision surgery for infected nonunion, two for removal of metalwork and exostectomy, and two for dynamization of the hindfoot nail. Conclusion Two-stage reconstruction of the infected and deformed Charcot foot using internal fixation and following the principle of ‘long-segment, rigid and durable internal fixation, with optimal bone opposition and local antibiotic elusion’ is a good form of treatment provided a multidisciplinary care plan is delivered. Cite this article: Bone Joint J 2021;103-B(10):1611–1618.

Charcot Foot—A Technique for Treatment of Chronic Plantar Ulcer by Saucerization and Primary Closure

Foot & Ankle ◽  
1986 ◽  
Vol 6 (6) ◽  
pp. 295-299 ◽  
Author(s):  
Edward O. Leventen
Keyword(s):  
Conservative Treatment ◽  
Primary Closure ◽  
Surgical Intervention ◽  
Plaster Cast ◽  
Charcot Foot ◽  
Foot Deformity ◽  
Suction Drainage ◽  
Plantar Ulcer ◽  
Charcot Feet

A series of four cases of refractory plantar ulcer in Charcot feet was successfully treated by a wide plantar exposure, excision of the ulcer, and primary closure over suction drainage. Thorough saucerization of the underlying convexity in the tarsals is thought to be necessary to achieve healing and prevent recurrence. Surgical intervention is considered worthwhile in those cases that show a marked rocker-bottom foot deformity on lateral radiography and have a persistent ulcer after conservative treatment in a plaster cast.

scholarly journals THE MANAGEMENT OF CHARCOT MIDFOOT DEFORMITIES IN DIABETIC PATIENTS

2013 ◽  
Vol 56 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Pavel Šponer ◽  
Tomáš Kučera ◽  
Jindra Brtková ◽  
Jaromír Šrot
Keyword(s):  
Soft Tissues ◽  
Acute Stage ◽  
Diabetic Patients ◽  
Susceptible Individual ◽  
Foot And Ankle ◽  
Charcot Foot ◽  
Foot Deformity ◽  
Deep Soft Tissue ◽  
Neuropathic Osteoarthropathy ◽  
Increased Pressure

Charcot foot neuropathic osteoarthropathy is a disorder affecting the soft tissues, joints, and bones of the foot and ankle. The disease is triggered in a susceptible individual through a process of uncontrolled inflammation leading to osteolysis, progressive fractures and articular malpositioning due to joint subluxations and dislocations. The progression of the chronic deformity with a collapsed plantar arch leads to plantar ulcerations because of increased pressure on the plantar osseous prominences and decreased plantar sensation. Subsequent deep soft tissue infection and osteomyelitis may result in amputation. The Charcot foot in diabetes represents an important diagnostic and therapeutic challenge in clinical practice. Conservative treatment remains the standard of the care for most patients with neuropathic disorder. Offloading the foot and immobilization based on individual merit are essential and are the most important recommendations in the active acute stage of the Charcot foot. Surgical realignment with stabilization is recommended in severe progressive neuropathic deformities consisting of a collapsed plantar arch with a rocker-bottom foot deformity.

Sign in / Sign up

Export Citation Format

Share Document