A proposed treatment algorithm for midfoot Charcot arthropathy.

Area of Science:

• Orthopedics
• Podiatry
• Diabetic Foot Care

Background:

• Charcot arthropathy (CA) is a severe condition affecting the foot and ankle.
• Effective treatment is crucial for improving patient outcomes and reducing mortality risk.

Purpose of the Study:

• To propose a treatment algorithm for midfoot Charcot arthropathy.
• To restore a plantigrade, shoeable foot in affected patients.

Main Methods:

• A case series report detailing a treatment algorithm for midfoot CA.
• Utilizing a combination of internal and external fixation techniques.
• Employing single-stage or multi-stage reconstruction based on ulceration and deformity severity.
• Medial column plating and circular external fixation for stabilization post-reduction.
• Immediate use of Charcot Restraint Orthotic Walker boot transitioning to diabetic shoeing.

Main Results:

• The proposed algorithm effectively corrects deformity and restores a plantigrade foot.
• Combined internal and external fixation provides robust stabilization.
• Multi-stage reconstruction addresses nonviable tissue and variable deformities.
• Swift transition to diabetic shoeing is facilitated.

Conclusions:

• The presented treatment algorithm offers an effective strategy for managing midfoot Charcot arthropathy.
• Restoring a functional, shoeable foot is achievable, improving quality of life.
• This approach aims to minimize complications and enhance long-term patient mobility.