Revisional Charcot Foot and Ankle Surgery

Diabetic Foot Ulcers — Treatment and Prevention

“…Complete blood cell count with differential, ESR, CRP, blood cultures, albumin, pre-albumin, chemistry panel, and glycosylated hemoglobin concentration (HbA1c) should be collected to rule out infection and determine metabolic competence. As was mentioned above, these values may be normal even in the presence of infection due to immunopathy secondary to diabetes [87]. If planning for surgical intervention, these values can also help to predict outcomes [87].…”

“…As was mentioned above, these values may be normal even in the presence of infection due to immunopathy secondary to diabetes [87]. If planning for surgical intervention, these values can also help to predict outcomes [87].…”

“…Most patients have bounding pulses in the acute phase, owing to vascular sympathetic denervation, although patients with chronic Charcot may have elements of vascular compromise. In cases with concurrent ulcerations or if considering surgical therapy, it may be beneficial to perform the ankle brachial index (ABI), arterial Doppler, and transcutaneous pulse oximetry (TcPO2) [73,81,87]. Special attention should be paid to the neurologic examination where extent of neuropathy can be assessed.…”

“…Considerations should be made to the patient's expectations with assessment of willingness to comply with post-operative recommendations before performing surgery [87,92].…”

“…The midfoot deformity reconstructions typically involve wedge shaped osteotomies or exostectomies [81,82,95]. Achilles tendon lengthening or tenotomy may be necessary to restore appropriate calcaneal sagittal position [73,79,82,87,95]. Hindfoot procedures are also approached with a mixture of fixation devices including screws, plates, intramedullary rodding and external fixators.…”