Is Rocker Bottom Reconstruction A Viable Option For Limb Preservation?

Start Page: 20
Here is a preoperative view of an ulcer secondary to a rocker bottom foot.
Here is a view of the same foot after surgeons performed an excision with a midfoot osteotomy.
One can now see a stable, braceable and functional foot with intact integument.
Here is a preoperative view of an ulceration secondary to a rocker bottom foot.
Here is a view of the same foot after a midfoot osteotomy with rotational flap coverage.
After surgeons utilized external fixation to protect flap closure, one can now see a stable, braceable and functional foot with intact integument.
Is Rocker Bottom Reconstruction A Viable Option For Limb Preservation?
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Author(s): 
By Scott Neville, DPM, Peter Blume, DPM, and Jonathan Key, DPM

Dr. Blume is a Clinical Assistant Professor in the Department of Orthopaedics and Rehabilitation at the Yale School of Medicine. He is also a Fellow of the American College of Foot and Ankle Surgeons, and is the Director of Limb Preservation at the Yale New Haven Hospital in New Haven, Conn.

Dr. Key is an Associate of the American College of Foot and Ankle Surgeons. He is in private practice with Affiliated Foot Surgeons and is an Attending Podiatrist at Yale New Haven Hospital, and the Hospital of Saint Raphael in New Haven, Conn.

Dr. Neville is a resident in the Department of Orthopedics and Rehabilitation within the Section of Podiatry at Yale New Haven Hospital in New Haven, Conn.

Dr. Steinberg is a faculty member of the Department of Surgery at the Georgetown University School of Medicine in Washington, D.C.




References:

1. Cooper PS. Application of external fixators for management of Charcot deformities of the foot and ankle. Foot and Ankle Clinics 2002 March;7(1):207-254.
2. Eichenholtz SN. Charcot Joints. Springfield (IL): Charles C. Thomas; 1996.
3. Myerson MS, Henderson MR, Saxby T, et al. Management of the midfoot diabetic neuroarthropathy. Foot and Ankle International. 1994; 15: 233-41.
4. Early JS, Hanson ST. Surgical reconstruction of the diabetic foot: a salvage approach for midfoot collapse. Foot and Ankle International. 1996; 17: 325-30.
5. Pinzur M. Surgical versus accommodative treatment for Charcot arthropathy of the midfoot. Foot Ankle Int. 2004 Aug;25(8):545-9.
6. Papa JS, Myerson MS, Girard P. Salvage with arthrodesis in intractable diabetic neuropathic arthropathy of the foot an ankle. Journal of Bone and Joint Surgery. 1993; 75A:10056-66.
7. Farber DC, Juliano PJ, Cavanagh PR, Ulbrecht J, Caputo G. Single stage correction with external fixation of the ulcerated foot in individuals with Charcot neuroarthropathy. Foot Ankle Int. 2002 Feb;23(2):130-4.





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