Surgical Reconstruction of the Charcot Rearfoot and Ankle

Burns, Patrick R.; Wukich, Dane K.

doi:10.1016/j.cpm.2007.10.008

Cited by 56 publications

(38 citation statements)

References 43 publications

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“…Charcot neuroosteoarthropathy of the feet is a major risk factor for foot deformity and ulceration with a subsequent rate of lower extremity amputation [3,5,29]. Nonoperative measures such as total contact casting are regarded as treatment of choice for a majority of patients if the treatment is likely to provide a plantigrade foot without major bony destruction and deformities [6,7,31].…”

Section: Discussionmentioning

confidence: 99%

“…Charcot neuroosteoarthropathy represents a devastating process that today is mostly observed in diabetic patients [2,5,7,12,22,23]. Quality of life is seriously impaired in patients with Charcot arthropathy more than in the average diabetic patient including a more profound limitation of physical activity than most severe medical illnesses [5,9].…”

Section: Introductionmentioning

confidence: 99%

“…Quality of life is seriously impaired in patients with Charcot arthropathy more than in the average diabetic patient including a more profound limitation of physical activity than most severe medical illnesses [5,9]. Charcot foot arthropathy increases the risk of skin breakdown, recurrent ulceration, and amputation secondary to foot deformity more than any other single condition [1,5,29]. At least 30% to 50% of patients with Charcot neuroosteoarthropathy are estimated to develop a recurrent ulceration [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Rearfoot and ankle Charcot deformities, though less common than midfoot disease, tend to be more unstable than midfoot disease and more likely to undergo subsequent surgery [5,36]. Identification of patients at-risk who already present with manifest ulceration or who are more likely to have skin ulceration over plantar bony prominences due to a nonplantigrade deformity or severe instability appears beneficial for timely decision-making in favor of surgical reconstruction [24,26].…”

Section: Introductionmentioning

confidence: 99%

“…Identification of patients at-risk who already present with manifest ulceration or who are more likely to have skin ulceration over plantar bony prominences due to a nonplantigrade deformity or severe instability appears beneficial for timely decision-making in favor of surgical reconstruction [24,26]. Early arthrodesis in the very unstable cases with a reduced period of total contact casting reportedly provides comparable results to patients treated nonoperatively [5,36].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Should One Consider Primary Surgical Reconstruction in Charcot Arthropathy of the Feet?

Mittlmeier

Klaue

Haar

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Charcot neuroosteoarthropathy of the feet can induce severe instability and deformity with subsequent plantar ulceration leading to substantial disability or even amputation. Traditionally, nonoperative treatment is regarded as the primary option of treatment while surgery is restricted to treating complications or failure of nonoperative treatment. Failed nonoperative treatment essentially prolongs treatment period. We retrospectively reviewed 22 patients (26 feet) with midfoot (n = 9) or hindfoot (n = 17) neuropathy who underwent primary surgical reconstruction and reorientation arthrodesis due to manifest instability, nonplantigrade foot position, and deformity with overt (n = 8) or what we judged was impending ulceration (n = 9). The minimum followup was 0.5 years (mean, 2.7 years; range 0.5-7 years). All eight ulcers healed without recurrence of ulceration or manifestation of new ulcers during the followup period. We observed complications leading to further surgery in nine patients: five with perioperative hematoma and four with instability.

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