Acta Med. 2014, 57: 127-132

Surgical Reconstruction of Charcot Foot Neuroarthropathy, a Case Based Review

Tomáš Kučeraa,b, Pavel Šponera,b, Jaromír Šrotb

aDepartment of Orthopedic Surgery, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic
bDepartment of Orthopedic Surgery, University Hospital in Hradec Králové, Czech Republic

Received March 26, 2014
Accepted September 10, 2014

Our case-based review focuses on limb salvage through operative management of Charcot neuroarthropathy of the diabetic foot. We describe a case, when a below-knee amputation was considered in a patient with chronic Charcot foot with a rocker-bottom deformity and chronic plantar ulceration. Conservative treatment failed. Targeted antibiotic therapy and operative management (Tendo-Achilles lengthening, resectional arthrodesis of Lisfranc and midtarsal joints, fixation with large-diameter axial screws, and plaster cast) were performed. On the basis of this case, we discuss options and drawbacks of surgical management. Our approach led to healing of the ulcer and correction of the deformity. Two years after surgery, we observed a significant improvement in patient’s quality of life. Advanced diagnostic and imaging techniques, a better understanding of the biomechanics and biology of Charcot neuroarthropathy, and suitable osteosynthetic material enables diabetic limb salvage.


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