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[Retrograde intramedullary nail fixation for Charcot neuroarthropathy]
E López-Gavito1, N A Gómez-Fuentes2, P Parra-Téllez1
1Servicio de Deformidades Neuromusculares, Tobillo y Pie. Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, CP 14389, Del. Tlalpan, Ciudad de México.
Surgical ankle arthrodesis using a blocked intramedullary nail effectively treats Charcot foot (neuropathy-driven arthropathy). This procedure improves foot function and reduces chronic ulcer occurrence, potentially preventing amputation.
Area of Science:
- Orthopedics
- Diabetic Foot Care
- Neuropathic Arthropathy
Background:
- Charcot arthropathy is a progressive, degenerative joint disease often linked to diabetic neuropathy.
- It causes destructive bone lesions in the foot and ankle due to impaired sensory perception.
- Surgical intervention is considered for severe cases with instability, ulcers, or functional limitations.
Purpose of the Study:
- To evaluate the efficacy of ankle arthrodesis with a blocked intramedullary nail in treating Charcot foot.
- To assess functional outcomes and complication rates in patients with Charcot neuropathy.
Main Methods:
- An observational, prospective, transversal, descriptive study.
- 16 patients with Brodsky type 3a Charcot neuropathy underwent surgical ankle arthrodesis.
- Treatment involved a blocked intramedullary nail, with follow-up for 4 years and 7 months.
Main Results:
- Preoperative AOFAS score averaged 35.0 ± 5.2.
- Postoperative AOFAS scores improved by an average of 40 points (p = 0.0001).
- The treatment led to bone stabilization and improved plantar foot support.
Conclusions:
- Ankle arthrodesis with a blocked intramedullary nail is an effective treatment for Charcot foot.
- This surgical approach stabilizes the foot, reduces chronic ulcer recurrence, and offers an alternative to amputation.
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