Management of neuropathic arthropathy with the Charcot Restraint Orthotic Walker

A recently designed Charcot Restraint Orthotic Walker (CROW) was used in the treatment of 18 patients with diabetic neuroarthropathy involving the foot and ankle. Eight of these patients had no surgery before the use of the CROW. In ten patients, the device was used for prolonged immobilization after surgery for complications of neuropathic joint disease. The CROW is a rigid, custom, full-foot enclosure ankle-foot orthosis. It was used after an initial period of cast immobilization. The CROW effectively controls limb edema, returns the patient to ambulatory activities, and prevents significant progression of deformity. All patients rated their satisfaction with the device as good or excellent. The CROW is an attractive alternative to currently used methods to provide the prolonged immobilization and protection necessary for healing in neuropathic arthropathy.