Abstract
The goals of Charcot deformity correction are to restore osseous alignment, regain
pedal stability, and prevent ulceration. Traditional reconstructive surgical approaches
involve large, open incisions to remove bone and the use of internal fixation to attempt
to fuse dislocated joints. Such operations can result in shortening of the foot and/or
incomplete deformity correction, fixation failure, incision healing problems, infection,
and the longterm use of casts or braces. We recommend a minimally invasive surgical
technique for the treatment of Charcot deformity, which we performed on 11 feet in
8 patients. Osseous realignment was achieved through gradual distraction of the joints
with external fixation, after which minimally invasive arthrodesis was performed with
rigid internal fixation. Feet were operated on at various stages of Charcot deformity:
Eichenholtz stage I (1 foot), Eichenholtz stage II (6 feet), and Eichenholtz stage
III (4 feet). When comparing the average change in preoperative and postoperative
radiographic angles, the transverse plane talar-first metatarsal angle (P = .02),
sagittal plane talar-first metatarsal angle (P = .008), and calcaneal pitch angle
(P = .001) were all found to be statistically significant. Complications included
3 operative adjustments of external or internal fixation, 4 broken wires or half-pins,
2 broken rings, and 11 pin tract infections. Most notably, no deep infection, no screw
failure, and no recurrent ulcerations occurred and no amputations were necessary during
an average follow-up of 22 months. Gradual Charcot foot correction with the Taylor
spatial frame plus minimally invasive arthrodesis is an effective treatment.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 24, 2010
Footnotes
Financial Disclosure: Smith & Nephew supports an educational course that is held by the International Center for Limb Lengthening.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
