Revisional Surgery of the Diabetic Charcot Foot and Ankle

• Published in: Clinics in podiatric medicine and surgery Vol. 34; no. 1; pp. 77 - 92
• Main Authors: Burns, Patrick R., DPM, Monaco, Spencer J., DPM
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2017
• Subjects: Arthrodesis; Arthropathy, Neurogenic - diagnostic imaging; Arthropathy, Neurogenic - pathology; Arthropathy, Neurogenic - surgery; Charcot neuroarthropathy; Diabetes mellitus; Diabetic Foot - diagnostic imaging; Diabetic Foot - pathology; Diabetic Foot - surgery; External Fixators; Female; Humans; Ilizarov external fixation; Internal Fixators; Male; Reoperation; Revisional foot and ankle surgery; Superconstruct; Surgery; Tibiotalocalcaneal arthrodesis; Treatment Failure; Superconstruct; Ilizarov external fixation; Tibiotalocalcaneal arthrodesis; Revisional foot and ankle surgery; Charcot neuroarthropathy; Diabetes mellitus
• ISSN: 0891-8422; 1558-2302
• DOI: 10.1016/j.cpm.2016.07.009

Charcot neuroarthropathy (CN) is a difficult problem for the foot and ankle surgeon. If surgery is required, little is known or available regarding the best methods and timing. When the initial attempt of reconstruction fails, revision of CN is even more demanding. One must take in to account all aspects, including nutrition, vascular status, infection control, short- and long-term blood glucose management, as well as other factors requiring laboratory monitoring and consult services. Once optimized, the biomechanics of the deformity can be addressed and decisions can be made on fixation devices.