2018, Number 1
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Acta Ortop Mex 2018; 32 (1)
Treatment algorithm for Charcot foot and surgical technique with circular external fixation
Rios-Ruh JM, Martin-Oliva X, Santamaría-Fumas A, Domínguez-Sevilla A, López-Capdevila L, Vilà y Rico J, Sales-Pérez JM
Language: English
References: 27
Page: 7-12
PDF size: 321.61 Kb.
ABSTRACT
Background: Charcot
neuroarthropathy (CNA), commonly known
as Charcot foot, is one of the most debilitating
complications of diabetes mellitus. Patients
with plantar ulcer and osteomyelitis (OM) due
to Charcot foot represent a high cost for health
systems and society in general. The amputation
risk for ulcerated Charcot patients is 12 times
higher than general population under 65 years old.
Material and methods: In this article we present
the CNA treatment protocol we use in our center.
We also make a detailed description of the surgical
technique «single stage surgery» with circular
external fixation.
Results: Our CNA treatment
protocol covers the most common presentations
of this severe neuropathic complication. With
the «single stage surgery» using circular external
fi xation we achieve an ulcer-free foot, successful
treatment of the OM, correction of the deformity,
diminished the cost of treatment, avoided
amputation and prevented recurrence of the ulcer.
Conclusions: The use of a treatment algorithm
based on the current literature, can be an
invaluable tool in the treatment of these complex
patients. The circular external fixation has proven
to be the only reliable tool for treating complex
Charcot foot in the context of poor bone stock,
active ulcers, soft tissues problems and OM.
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