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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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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.
Abstract:
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living.
Material And Methods:
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living.
Design:
observational, prospective, transversal, descriptive.
Sample:
patients diagnosed with Charcot neuropathy type 3a of Brodsky. Surgically treated by ankle arthrodesis with an intramedullary blocked nail, from January 2010 to August 2015.
Results:
16 patients were analyzed. Preoperative AOFAS score was 35.0 ± 5.2 points. Postoperative follow-up period of 4 years to 7 months. Postoperative AOFAS scale showed an improvement of 40 points (p = 0.0001).
Conclusions:
The proposed treatment allows bone stabilization, resulting in a full foot plantar support and decreases the occurrence of chronic ulcers that are difficult to treat, and is an alternative method that avoids lead to amputation.
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