Medial column rodding facilitated by transitional osteochondral graft

Area of Science:

• Orthopedic surgery
• Podiatric medicine
• Biomedical engineering

Background:

• Charcot neuro-arthropathy often requires surgical reconstruction, posing challenges for preserving joint integrity.
• Traditional methods may compromise joint cartilage during screw placement for medial column stabilization.

Observation:

• A novel technique was employed for a patient with midfoot Charcot neuro-arthropathy, involving a headless screw inserted into the first metatarsal head.
• A portion of the osteochondral surface was temporarily removed to allow perpendicular screw positioning across medial column joints.

Findings:

• Serial radiographs demonstrated successful osteochondral graft incorporation and maintained alignment and stability.
• The patient exhibited preserved joint motion and function, with no signs of degeneration or pain at 45 months post-surgery.

Implications:

• This case report is the first to describe using a local osteochondral graft for screw passage in foot reconstruction.
• The technique shows potential for joint preservation during medial column stabilization, warranting further investigation for long-term outcomes.