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The development of a neuropathic ankle following successful correction of non-plantigrade charcot foot deformity.
Foot Ankle Int. 2012 Aug; 33(8):644-6.FA

Abstract

BACKGROUND

The treatment of Charcot foot arthropathy has traditionally involved immobilization during the acute phase followed by longitudinal management with accommodative bracing. In response to the perceived poor outcomes associated with nonoperative accommodative treatment, many experts now advise surgical correction of the deformity, especially when the affected foot is not clinically plantigrade. The significant rate of surgical and medical-associated morbidity accompanying this form of treatment has led surgeons to look for improved methods of surgical stabilization, including the use of the circular ring external fixation.

METHODS

Over a 7-year period, a single surgeon performed surgical correction of non-plantigrade Charcot foot deformity on 171 feet in 164 patients with a statically applied circular external fixator. Following successful correction, five patients developed a neuropathic deformity of the ipsilateral ankle after removal of the external fixator and subsequent weight bearing total contact cast.

RESULTS

Three of the five patients progressed to successful healing of the neuropathic (Charcot) ankle arthropathy following treatment with a series of weightbearing total contact casts. Two underwent successful ankle fusion with retrograde locked intramedullary nailing.

DISCUSSION

This unusual clinical scenario likely represents either a progression of the disease process in the foot or a complication associated with surgical correction of the original neuropathic foot deformity. A better understanding of this observation will likely become apparent as we acquire more experience with this disorder.

Authors+Show Affiliations

Loyola University Health System, Orthopaedic Surgery, 2160 South First Avenue, Maywood, IL 60153, USA. mpinzu1@lumc.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22995231

Citation

Pinzur, Michael S.. "The Development of a Neuropathic Ankle Following Successful Correction of Non-plantigrade Charcot Foot Deformity." Foot & Ankle International, vol. 33, no. 8, 2012, pp. 644-6.
Pinzur MS. The development of a neuropathic ankle following successful correction of non-plantigrade charcot foot deformity. Foot Ankle Int. 2012;33(8):644-6.
Pinzur, M. S. (2012). The development of a neuropathic ankle following successful correction of non-plantigrade charcot foot deformity. Foot & Ankle International, 33(8), 644-6.
Pinzur MS. The Development of a Neuropathic Ankle Following Successful Correction of Non-plantigrade Charcot Foot Deformity. Foot Ankle Int. 2012;33(8):644-6. PubMed PMID: 22995231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The development of a neuropathic ankle following successful correction of non-plantigrade charcot foot deformity. A1 - Pinzur,Michael S, PY - 2012/9/22/entrez PY - 2012/9/22/pubmed PY - 2012/11/2/medline SP - 644 EP - 6 JF - Foot & ankle international JO - Foot Ankle Int VL - 33 IS - 8 N2 - BACKGROUND: The treatment of Charcot foot arthropathy has traditionally involved immobilization during the acute phase followed by longitudinal management with accommodative bracing. In response to the perceived poor outcomes associated with nonoperative accommodative treatment, many experts now advise surgical correction of the deformity, especially when the affected foot is not clinically plantigrade. The significant rate of surgical and medical-associated morbidity accompanying this form of treatment has led surgeons to look for improved methods of surgical stabilization, including the use of the circular ring external fixation. METHODS: Over a 7-year period, a single surgeon performed surgical correction of non-plantigrade Charcot foot deformity on 171 feet in 164 patients with a statically applied circular external fixator. Following successful correction, five patients developed a neuropathic deformity of the ipsilateral ankle after removal of the external fixator and subsequent weight bearing total contact cast. RESULTS: Three of the five patients progressed to successful healing of the neuropathic (Charcot) ankle arthropathy following treatment with a series of weightbearing total contact casts. Two underwent successful ankle fusion with retrograde locked intramedullary nailing. DISCUSSION: This unusual clinical scenario likely represents either a progression of the disease process in the foot or a complication associated with surgical correction of the original neuropathic foot deformity. A better understanding of this observation will likely become apparent as we acquire more experience with this disorder. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/22995231/The_development_of_a_neuropathic_ankle_following_successful_correction_of_non_plantigrade_charcot_foot_deformity_ L2 - https://journals.sagepub.com/doi/10.3113/FAI.2012.0644?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -