Abstract
Charcot neuroarthropathy is a complication of the joints in patients with peripheral neuropathy, characterized by massive hyperemia, bone resorption, and joint destruction. The complex deformities that can result may lead to subsequent ulcers, osteomyelitis, and eventually limb amputation. Concurrent soft-tissue pathologies, such as ulcers and infections, complicate operative management. Thus, deformity correction may be necessary for wound healing before final fixation. In this case report, the authors describe a 48-year-old man who presented with a severe Charcot deformity of the foot and accompanying non-healing diabetic foot ulcer overlying the talar head. The authors elected to proceed with staged reconstruction, starting with circular external fixation (CEF) in conjunction with gradual computer program-assisted correction. This was followed by midfoot and hindfoot fusion with internal fixation for deformity correction and application of a static CEF with Achilles tenotomy. Radiographs demonstrated improved alignment, congruent joints, maintenance of reduction, and proper hardware placement. The foot was plantigrade and ulcer free at 20-month follow-up. Application of CEF with gradual correction is a reasonable alternative that is minimally invasive and particularly beneficial in patients with a poor soft-tissue envelope. CEF is a limb-preservation approach and avoids the need for amputation.
Recommended Citation
Transtrum, M Bryant; Allen Wang; Diego Sanchez; Joshua Tadlock; Ahmed Thabet; and Amr Abdelgawad. "Reconstruction of Charcot Foot Deformity Using Circular External Fixators and Fusion: A Case Report." Western Journal of Orthopaedics 12, 1 (2023). https://digitalrepository.unm.edu/wjo/vol12/iss1/8