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Treatment algorithm for Charcot foot and surgical technique with circular external fixation

J M Rios-Ruh1, X Martin-Oliva2, A Santamaría-Fumas1

  • 1Department of Orthopaedics. Consorci Sanitari Integral. Barcelona, Spain.

Acta Ortopedica Mexicana
|September 6, 2018
PubMed

Insights

Charcot foot (CNA) treatment involves a specific protocol and single-stage surgery with circular external fixation. This approach effectively heals ulcers, treats osteomyelitis (OM), corrects deformities, and prevents amputation.

Area of Science:

  • Diabetic complications
  • Orthopedic surgery
  • Podiatric medicine

Background:

  • Charcot neuroarthropathy (CNA), or Charcot foot, is a severe diabetic complication.
  • Plantar ulcers and osteomyelitis (OM) in Charcot foot significantly increase healthcare costs and amputation risk.
  • Amputation risk for ulcerated Charcot patients is 12 times higher than the general population under 65.

Purpose of the Study:

  • To present a comprehensive treatment protocol for Charcot neuroarthropathy (CNA).
  • To detail the single-stage surgical technique using circular external fixation for CNA.
  • To evaluate the efficacy of this protocol and surgical technique in managing complex cases.

Main Methods:

  • A standardized treatment protocol for Charcot neuroarthropathy (CNA) was implemented.
  • A "single-stage surgery" technique utilizing circular external fixation was employed.
  • The protocol addresses common presentations of this diabetic complication.

Main Results:

  • The treatment protocol effectively managed various Charcot foot (CNA) presentations.
  • Single-stage surgery with circular external fixation resulted in ulcer-free feet.
  • This surgical approach successfully treated osteomyelitis (OM), corrected deformities, and prevented ulcer recurrence.

Conclusions:

  • A structured treatment algorithm is crucial for managing complex Charcot foot (CNA) patients.
  • Circular external fixation is a reliable tool for treating severe Charcot foot (CNA) with poor bone stock, ulcers, and OM.
  • The presented method reduces treatment costs and avoids amputation.
Abstract

Keywords:
Charcot neuroarthropathyalgorithmdiabetesosteomyelitisstatic circular fixationulcer

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