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[Arthrodesis with subsequent screw fixation in the treatment of diabetic Charcot hind- and midfoot arthropathy].
Z Orthop Unfall. 2011 Aug; 149(4):402-6.ZO

Abstract

BACKGROUND

Surgical reconstruction of Charcot arthropathy in diabetes is characterised by long consolidation periods and extensive osteosynthesis procedures. The different methods of osteosynthesis are difficult to compare. Studies differ in many aspects such as favourable outcome, timing of surgery, clinical features, severity and stage of the disease. Therefore uniformity and comparability of the studies is not given. An evidence-based therapy algorithm for the surgical reconstruction of Charcot feet does not exist.

PATIENTS AND METHODS

A retrospective study of twelve patients with 13 affected feet who had undergone arthrodesis of the foot to treat Charcot deformity was performed. All surgical procedures were performed at Eichenholtz stage 3. Six patients showed an ulcer of the foot at the time of surgery, six patients were without pedal ulceration. Screw fixation was used for reconstruction and bone grafting was performed in all patients. Radiographic measurements were recorded preoperatively, immediately postoperatively, 3 months postoperatively and at the time of the last follow-up. Patients were evaluated clinically and radiographically at an average of 2.4 years.

RESULTS

Complete osseous union was achieved in ten patients at an average of 4.3 months. There was one patient with a postoperative infection and an internal amputation, one patient with an unstable non-union, with recurrence of deformity. All pedal ulcers healed during the period of the osseous consolidation. All patients returned to an ambulatory status within 7 months.

CONCLUSIONS

Open reduction and arthrodesis with the use of screw fixation alone for the surgical correction of Charcot arthropathy provide a good result compared to other fixation methods.

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Authors+Show Affiliations

Waldecker U
Orthopädie, Hufeland Klinik, Taunusallee 5, Bad Ems. utewaldecker@t-online.de

MeSH

AdultAgedArthrodesisArthropathy, NeurogenicBone ScrewsBone TransplantationDiabetic FootFemaleHumansMaleMiddle AgedPostoperative ComplicationsRadiographyRecurrenceRetrospective Studies

Pub Type(s)

Journal Article

Language

ger

PubMed ID

21553371

Citation

Waldecker, U. "[Arthrodesis With Subsequent Screw Fixation in the Treatment of Diabetic Charcot Hind- and Midfoot Arthropathy]." Zeitschrift Fur Orthopadie Und Unfallchirurgie, vol. 149, no. 4, 2011, pp. 402-6.
Waldecker U. [Arthrodesis with subsequent screw fixation in the treatment of diabetic Charcot hind- and midfoot arthropathy]. Z Orthop Unfall. 2011;149(4):402-6.
Waldecker, U. (2011). [Arthrodesis with subsequent screw fixation in the treatment of diabetic Charcot hind- and midfoot arthropathy]. Zeitschrift Fur Orthopadie Und Unfallchirurgie, 149(4), 402-6. https://doi.org/10.1055/s-0030-1271049
Waldecker U. [Arthrodesis With Subsequent Screw Fixation in the Treatment of Diabetic Charcot Hind- and Midfoot Arthropathy]. Z Orthop Unfall. 2011;149(4):402-6. PubMed PMID: 21553371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Arthrodesis with subsequent screw fixation in the treatment of diabetic Charcot hind- and midfoot arthropathy]. A1 - Waldecker,U, Y1 - 2011/05/06/ PY - 2011/5/10/entrez PY - 2011/5/10/pubmed PY - 2012/2/9/medline SP - 402 EP - 6 JF - Zeitschrift fur Orthopadie und Unfallchirurgie JO - Z Orthop Unfall VL - 149 IS - 4 N2 - BACKGROUND: Surgical reconstruction of Charcot arthropathy in diabetes is characterised by long consolidation periods and extensive osteosynthesis procedures. The different methods of osteosynthesis are difficult to compare. Studies differ in many aspects such as favourable outcome, timing of surgery, clinical features, severity and stage of the disease. Therefore uniformity and comparability of the studies is not given. An evidence-based therapy algorithm for the surgical reconstruction of Charcot feet does not exist. PATIENTS AND METHODS: A retrospective study of twelve patients with 13 affected feet who had undergone arthrodesis of the foot to treat Charcot deformity was performed. All surgical procedures were performed at Eichenholtz stage 3. Six patients showed an ulcer of the foot at the time of surgery, six patients were without pedal ulceration. Screw fixation was used for reconstruction and bone grafting was performed in all patients. Radiographic measurements were recorded preoperatively, immediately postoperatively, 3 months postoperatively and at the time of the last follow-up. Patients were evaluated clinically and radiographically at an average of 2.4 years. RESULTS: Complete osseous union was achieved in ten patients at an average of 4.3 months. There was one patient with a postoperative infection and an internal amputation, one patient with an unstable non-union, with recurrence of deformity. All pedal ulcers healed during the period of the osseous consolidation. All patients returned to an ambulatory status within 7 months. CONCLUSIONS: Open reduction and arthrodesis with the use of screw fixation alone for the surgical correction of Charcot arthropathy provide a good result compared to other fixation methods. SN - 1864-6743 UR - https://www.unboundmedicine.com/medline/citation/21553371/[Arthrodesis_with_subsequent_screw_fixation_in_the_treatment_of_diabetic_Charcot_hind__and_midfoot_arthropathy]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0030-1271049 DB - PRIME DP - Unbound Medicine ER -