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Updated: Jun 18, 2026
09:01
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
[Reconstructive surgery for Charcot foot. Long-term 5-year outcome]
U Illgner1, M Podella, M Rümmler
1Klink für Technische Orthopädie, Universität Münster, Münster, Deutschland. ulrich_illgner@web.de
Der Orthopade
|November 19, 2009
Summary
Surgical correction using external fixators for diabetic neuropathic osteoarthropathy (DNOAP) effectively avoids amputations and improves patient mobility. Interdisciplinary collaboration is key for successful long-term outcomes in DNOAP treatment.
Area of Science:
- Orthopedics
- Diabetology
- Podiatry
Context:
- Diabetic neuropathic osteoarthropathy (DNOAP) leads to foot deformities, ulcers, and high amputation risk.
- Limited long-term outcome data exists for DNOAP interventions.
- This study presents the largest follow-up cohort for DNOAP surgical management.
Purpose:
- To evaluate the long-term effectiveness of surgical interventions for complex foot malpositioning and chronic ulcers in DNOAP patients.
- To assess the rates of amputation avoidance and patient activity improvement.
- To identify factors contributing to successful long-term outcomes.
Summary:
- A retrospective study analyzed 205 procedures (195 patients) for DNOAP using external fixators or Steinmann pins.
- Average follow-up was 21 months, with goals of pain-free ambulation and amputation avoidance.
- No primary amputations were performed; 15 secondary amputations were necessary. Patient activity improved, and 50% mobilized in custom shoes by 18 months.
Impact:
- External fixator use significantly reduced amputations in DNOAP patients.
- Patient activity levels improved, with enhanced mobility and function.
- Interdisciplinary teamwork among orthopedic surgeons, shoemakers, and technicians is crucial for sustained DNOAP treatment success.
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