Different approach to charcot neuroarthropathy: A case report

Area of Science:

• Orthopedics
• Diabetic Foot Management
• Surgical Innovation

Background:

• Charcot neuroarthropathy (CN) is a progressive, disabling condition in diabetic patients affecting the ankle and foot.
• Surgical management, particularly ankle arthrodesis, seeks to achieve a stable, plantigrade foot but often has high failure rates.
• Late-stage CN deformities present significant challenges for effective treatment.

Observation:

• Two cases of late-stage Charcot neuroarthropathy foot deformity were presented.
• Case 1: A 52-year-old female with left ankle CN, no infection or prior surgery.
• Case 2: A 47-year-old male with right ankle CN, a history of external fixator use, and current surgical site infection.

Findings:

• Ankle arthrodesis is a primary treatment for severe, late-stage CN foot, aiming for joint stability and prevention of tissue destruction.
• Internal plate fixation combined with a fibular strut graft demonstrated promising radiographic and functional results in both presented cases.
• Minimal implant techniques and iliac grafts are potential alternative or adjunctive treatment modifications.

Implications:

• Internal plate fixation with fibular strut graft offers a viable surgical strategy for complex Charcot neuroarthropathy.
• Further research into modified techniques, including minimal implants and autografts, may improve outcomes.
• Successful surgical management can significantly improve patient function and quality of life in diabetic foot complications.