A Closer Look At Fixation Options For The Charcot Foot

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This preoperative X-ray shows a rocker bottom deformity with chronic ulceration on the plantar lateral aspect.
Here is another preoperative X-ray view of the rocker bottom deformity with chronic ulceration on the plantar lateral aspect.
This postoperative X-ray shows the use of midfoot and rearfoot arthrodesis employing a medial and lateral rodding technique with internal fixation.
This postoperative X-ray shows the use of midfoot and rearfoot arthrodesis employing a medial and lateral rodding technique with internal fixation.
A Closer Look At Fixation Options For The Charcot Foot
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Author(s): 
By John Giurini, DPM

In Conclusion

   Finally, no matter how much you discuss, describe and prepare the patient for the fact that he or she will be living with this frame for three months, almost all patients are in a state of shock when they wake from anesthesia and discover this “contraption” attached to their leg.

   When it comes down to removing the frame, it is dictated by the patient tiring of the device as much as the clinical result. In our practice, we have resorted to showing the surgical patient a completed frame attached to a sawbone so he or she can appreciate the impact of the device.

Dr. Giurini is the Chief of the Division of Podiatric Surgery at the Beth Israel Deaconess Medical Center in Boston.

Dr. Steinberg (shown at right) is an Assistant Professor in the Department of Surgery at the Georgetown University School of Medicine in Washington, D.C. He is a Fellow of the American College of Foot and Ankle Surgeons.

For related articles, see “Active Charcot: Should You Proceed With Surgery?” in the March 2005 issue of Podiatry Today or “Key Considerations In Managing The Charcot Foot” in the May 2005 issue.

Also be sure to check out the archives at www.podiatrytoday.com.




References:

1. Personal communication with Bradley Lamm, DPM.

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