THE MANAGEMENT OF CHARCOT MIDFOOT DEFORMITIES IN DIABETIC PATIENTS

Šponer, Pavel; Kučera, Tomáš; Brtková, Jindra; Šrot, Jaromír

doi:10.14712/18059694.2014.30

Acta Medica > Archive > 2013, Vol. 56 > Issue 1 > THE MANAGEMENT OF CHARCOT MIDFOOT…

Acta Med. 2013, 56: 3-8

https://doi.org/10.14712/18059694.2014.30

THE MANAGEMENT OF CHARCOT MIDFOOT DEFORMITIES IN DIABETIC PATIENTS

Pavel Šponer^a,b, Tomáš Kučera^a,b, Jindra Brtková^c, Jaromír Šrot^b

^aCharles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic: Department of Orthopaedic Surgery
^bUniversity Hospital in Hradec Králové, Czech Republic: Department of Orthopaedic Surgery
^cUniversity Hospital in Hradec Králové, Czech Republic: Department of Diagnostic Radiology

Charcot foot neuropathic osteoarthropathy is a disorder affecting the soft tissues, joints, and bones of the foot and ankle. The disease is triggered in a susceptible individual through a process of uncontrolled inflammation leading to osteolysis, progressive fractures and articular malpositioning due to joint subluxations and dislocations. The progression of the chronic deformity with a collapsed plantar arch leads to plantar ulcerations because of increased pressure on the plantar osseous prominences and decreased plantar sensation. Subsequent deep soft tissue infection and osteomyelitis may result in amputation. The Charcot foot in diabetes represents an important diagnostic and therapeutic challenge in clinical practice. Conservative treatment remains the standard of the care for most patients with neuropathic disorder. Offloading the foot and immobilization based on individual merit are essential and are the most important recommendations in the active acute stage of the Charcot foot. Surgical realignment with stabilization is recommended in severe progressive neuropathic deformities consisting of a collapsed plantar arch with a rocker-bottom foot deformity.