Charcot foot reconstruction with combined internal and external fixation: case report

Capobianco, Claire M.; Ramanujam, Crystal L.; Zgonis, Thomas

doi:10.1186/1749-799x-5-7

Cited by 24 publications

(20 citation statements)

References 25 publications

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“…Patients with a history of Charcot neuroarthropathy often develop chronic foot ulcerations and altered gait patterns secondary to deformity caused by severe joint collapse. 19 Interestingly in our study group, a history of Charcot neuroarthropathy to either the grafted extremity or contralateral side did not have a statistically significant effect on healing time.…”

Section: Discussionmentioning

confidence: 89%

Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds

Ramanujam

Stapleton

Kilpadi

et al. 2010

Foot & Ankle Specialist

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The aim of this study was to determine if split-thickness skin grafts could be successfully used for closure of foot and ankle wounds in diabetic patients. The authors retrospectively reviewed the charts of 100 consecutive patients who underwent a soft tissue surgical reconstruction with split-thickness skin grafts to their foot and/or ankle in our institution from 2005 to 2008. After application of inclusion criteria, 83 eligible charts remained. Of the 83 patients, 54 (65%) healed uneventfully, 23 (28%) required regrafting, and 6 (7%) had a complication resolved with conservative management. All patients had a successful surgical outcome, defined as having achieved complete wound closure at the final follow-up. Surgical outcome was not significantly associated with age, gender, race, hemoglobin A1C, wound size, wound location, illicit drug use, amputation history, Charcot history, or preoperative infection. However, postoperative graft complications were significantly associated with current or previous smoking history (P = .016) and the level of previous pedal amputation to which the split-thickness skin graft was applied (P = .009). This study demonstrates that application of split-thickness skin grafts with an appropriate postoperative regimen is a beneficial procedure to achieve foot and ankle wound closure in diabetic patients.

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Section: Discussionmentioning

confidence: 89%

Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds

Ramanujam

Stapleton

Kilpadi

et al. 2010

Foot & Ankle Specialist

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“…Most external devices use tensioned wires to stabilize multiple planes and promote inter-fragmentary compression to prevent implant loosing, neutralize stress placed on the foot, and assist in deformity correction. 112,120,121 Complications resulting from external fixation are more common in diabetic patients and include pin loosening, pin breakage, pin failure, stress fractures, osteomyelitis, and pin tract infections. 122 If surgical correction requires arthrodesis, the use of bone graft and/or adjuvants may be necessary.…”

Section: Charcot Neuropathic Osteoarthropathy (Cn): Treatment and Chamentioning

confidence: 99%

The Biology of Bone and Ligament Healing

Cottrell

Turner

Arinzeh

et al. 2016

Foot and Ankle Clinics

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This review describes the normal healing process for bone, ligaments, and tendons, including primary and secondary healing as well as bone-to-bone fusion. It depicts the important mediators and cell types involved in the inflammatory, reparative, and remodeling stages of each healing process. It also describes the main challenges for clinicians when trying to repair bone, ligaments, and tendons with a specific emphasis on Charcot neuropathy, fifth metatarsal fractures, arthrodesis, and tendon sheath and adhesions. Current treatment options and research areas are also reviewed.

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“…External fixation can be used on its own or in conjunction with internal fixation when severe instability or gross deformity is present ( 62 ). Bone quality is less of a concern with the use of external fixation as it does not rely on cortical purchase for stabilization.…”

Section: Surgical Management Of the Acute Charcot Foot And Anklementioning

confidence: 99%

A literature-based guide to the conservative and surgical management of the acute Charcot foot and ankle

Schade

Andersen

2015

Diabetic Foot & Ankle

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Acute Charcot neuroarthropathy of the foot and ankle presents with the insidious onset of a unilateral acutely edematous, erythematous, and warm lower extremity. The acute stages are typically defined as Eichenholtz Stage 1, or Stage 0, which was first described by Shibata et al. in 1990. The ultimate goal of treatment is maintenance of a stable, plantigrade foot which can be easily shod, minimizing the risk of callus, ulceration, infection, and amputation. The gold standard of treatment is non-weight-bearing immobilization in a total contact cast. Surgical intervention remains controversial. A review of the literature was performed to provide an evidenced-based approach to the conservative and surgical management of acute Charcot neuroarthropathy of the foot and ankle.

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Charcot foot reconstruction with combined internal and external fixation: case report

Cited by 24 publications

References 25 publications

Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds

Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds

The Biology of Bone and Ligament Healing

A literature-based guide to the conservative and surgical management of the acute Charcot foot and ankle

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