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

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.