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Charcot Foot and Ankle, also known as Charcot arthropathy, is a progressive, inflammatory condition that affects the bones, joints, and soft tissues in the feet of people with peripheral neuropathy. If left untreated, Charcot of the foot and ankle leads to severe deformity, ulceration, and – worst-case scenario – to limb amputation.
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When dealing with Charcot Foot Disease, a swift diagnosis is crucial to improve patient outcomes and avoid complications such as foot deformity, ulceration, and in a worst-case scenario, limb amputation. However, not all physicians are able to recognize the initial signs of a Charcot Foot and Ankle in their diabetic patients.
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Weigh bearing is considered a significant clinical issue particularly when an external fixator has been applied to a lower limb. If mechanical stability is in fact a mandatory condition for promoting fracture healing, other key components for a full recovery of the bone are early weight bearing and dynamization.
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In the compression-distraction technique, one site of the bone is lengthened and another site is immediately or gradually compressed. In the lower limb, the compression-distraction technique is generally performed in the presence of leg shortening associated with small bone defects – less than 3cm in the tibia and/or less than 5cm in the femur.
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Diabetic foot is one of the most important sources of morbidity in patients with diabetes, affecting 6.4% of patients worldwide. It is the most common cause of lower extremity amputation.
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Charcot Neuroarthropathy, also called Charcot Foot and Ankle, is a progressive and inflammatory condition that weakens the soft tissues, bones, and joints of the foot and ankle. This complex and challenging type of neuropathic arthropathy is commonly linked to diabetes. If left untreated, it can lead to devastating consequences, such as deformity, ulceration, and infection. In the worst-case scenario, it may result in limb amputation.
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To prevent and manage pin site problems, the patient should be clearly informed of the protocol he/she needs to follow for pin site care in the post-operative phase. And not only the patient, but all people involved in the healing process outside the hospital should know the protocol.
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Dynamization (dynamic loading and controlled motion at the fracture site) is considered a controversial and evolving issue, besides the positive functional results observed both in experimental studies based on animal models, and in human clinical cases in the last 30 years. Currently one crucial matter is to understand the biomechanical, biological and physiological effects of dynamization on the bone healing process, in order to show its safety and effectiveness.
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When an orthopedic surgeon has to perform a bone deformity correction, he or she may choose to apply an extrinsic method of correction such us an external fixator, or an intrinsic one, such us an intramedullary nail. In both cases, a surgeon will always have to consider the patient’s bone quality through three dimensional parameters: length, alignment and torsion, and accurately the entire 3D correction process. If using an intramedullary nail, an effective planning method is the Reverse Planning Method (RPM) developed by Prof. Rainer Baumgart in 2009.(1)
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Charcot Foot and Ankle is a complex, challenging and sometimes devastating inflammatory foot disease which causes loss of sensation, weakening of the bones and collapse of the weight bearing joints. Most often due to diabetes and underlying neuropathic arthropathy, it needs a multidisciplinary team approach in order to treat it properly and prevent amputation.
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