Approach to Charcot Neuroarthropathy of the Great Toe: A Case Report

Charcot neuroarthropathy (CN) is a chronic progressive debilitating disease affecting joints, bone and soft tissue of an insensate limb, usually seen in patients with diabetes. CN of the great toe is rare or it may be associated with CN of other joints. Only a few cases have been reported on the CN of the great toe. Stabilization and offloading is the primary aim of the treatment of CN. The present case report highlights the presentation, diagnosis and management of CN of the great toe. A 56-year-old male patient with diabetes presented to our outpatient department with post-traumatic swelling of the great toe with blackish discoloration and scanty, purulent discharging sinus. Based on the clinical and radiological findings, it was diagnosed to be the CN of the great toe, which was stabilized with a Kirschner wire. Clinical improvement and new bone formation were seen and the great toe was stabilized in acceptable alignment. Diagnosing CN of the great toe is challenging and needs both clinical and radiological evaluation. Stabilization with a single Kirschner wire is a simple, low-cost procedure, which can be done under a digital block in a minor operation theatre. Immediate mobilization and weight-bearing are allowed with good radiological and functional outcomes.