Charcot Foot: Its Functional Reconstruction and Salvage

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• 作者：F. Noriega^a ; ^{dr.noriega@iicop.com} ; P. Villanueva^a ; S.T. Hansen Jr^b
• 关键词：Charcot ; diabetes ; arthrodesis ; bone fragmentation ; flatfoot
• 刊名：Revista Espa?ola de Cirug¨ªa Ortop¨¦dica y Traumatolog¨ªa (English Edition)
• 出版年：2007
• 出版时间：May-June 2007
• 年：2007
• 卷：51
• 期：3
• 页码：164-172
• 全文大小：704 K

文摘

Charcot foot can be defined as a neuroarthropathy leading to foot deformity and often progressive degeneration. It is frequently evidenced by dislocations and fractures, instability and, in some cases, ulceration. When surgery is considered, the traditional approach for most cases has been below- knee amputation, but as greater experience is gained in foot and ankle reconstruction procedures, the salvage of these feet has become a possibility. Charcot foot reconstruction is indicated when the soft tissues are at risk, the foot is unstable or the shape of the foot prevents it fitting into a normal shoe. In most cases, realignment and fusion of the ankle, subtalar, talonavicular, and possibly of other medial column joints is necessary, along with a gastroc slide or Achilles tendon lengthening as excessive plantar flexion is often the initiating force for breakdown in the midfoot, the most commonly affected area.

Resection of plantar prominences may be needed to prevent ulceration from high pressure. This is successful when autofusion has occurred above the prominence; without fusion, resection is generally followed by more significant collapse and recurrence of prominences and/or ulceration.