Midtarsal Reconstructive Arthrodesis Using a Multi-Axial Correction Fixator in Charcot Midfoot Arthropathy

Area of Science:

• Orthopedic Surgery
• Diabetic Foot Complications
• External Fixation Devices

Background:

• Charcot foot reconstruction presents significant challenges due to comorbidities like poor bone quality and impaired vascularity.
• Existing fixation devices have limitations in managing complex midfoot Charcot neuroarthropathy.

Purpose of the Study:

• To evaluate the efficacy of the Multi-Axial Correction (MAC) monolateral external fixation system for midfoot Charcot neuroarthropathy reconstruction.
• To assess surgical outcomes, including union, deformity correction, and functional ambulation.

Main Methods:

• A case series of 11 feet with midfoot Charcot arthropathy treated with the MAC system, alone or with minimal internal fixation.
• Therapeutic, Level IV evidence was gathered.
• Postoperative follow-up averaged 29 months, with MAC system removal at a mean of 8.7 weeks.

Main Results:

• Successful union and correction of rocker bottom deformity were achieved in all patients.
• No pin tract infections or limb amputations occurred.
• All patients achieved ambulation, with most using custom diabetic footwear.

Conclusions:

• The MAC external fixation system is a viable and straightforward option for surgical treatment of midfoot Charcot arthropathy.
• This method demonstrates good functional outcomes and avoids major complications like amputation.