Background: Charcot neuroarthropathy is a non-infective, destructive process occurring in patients rendered insensate by peripheral neuropathy, which is caused mainly by diabetes. Repetitive trauma from standing and walking provides a neuro-traumatic stimulus that leads to dislocation, or peri-articular fracture, or both, within the ankle. This review concentrates on the management protocols regarding the ankle only. Methods: A Pubmed search for clinical trials performed to manage ankle Charcot neuroarthropathy and a systematic review of these articles were undertaken. Results: Twenty papers met the inclusion criteria: four of them describe non-surgical management, while the rest show different surgical management options of ankle Charcot neuroarthropathy. Conclusions: Surgical algorithms for the treatment of CN of the ankle are based almost entirely on level four. There is inconclusive evidence concerning the timing of treatment and the use of different fixation methods. Instability and ulceration are the main precursors for surgical interventions. Prospective series and randomized studies, albeit difficult to perform, are necessary to support and strengthen current practice.
Hindfoot arthrodesis is a common orthopedic surgical procedure indicated for reconstructive surgery in patients with advanced osteoarthritis, rheumatoid arthritis, posterior tibial tendon insufficiency (stages III and IV), severe cases of tarsal coalition, advanced stages of cavovarus foot (eg, Charcot-Marie-tooth disease), or type 2 Brodsky Charcot hindfoot arthropathy. Triple arthrodesis utilizing solid (noncannulated) screws is a technically demanding procedure because accurate placement of these screws is complex. Cannulated screws have become popular because of their easier insertion than solid screws and because of a lower chance of loss of reduction during insertion. The traditional triple hindfoot arthrodesis is performed using 2 separate incisions and also by the single medial approach with cannulated screws. Both procedures are described and illustrated in detail in this paper. We recommend inserting screws starting with the joint that has the greatest preoperative deformity and address soft tissue contractures if needed earlier during surgery. Appropriate placement of screws is very important for stable reconstruction and good postoperative outcomes.
Wireless LAN, in the current state of the world, has become ubiquitous. Therefore it is imperative to safeguard this technology, which otherwise could prove disastrous. Compromised WLANs, have the potential to leave the user susceptible to a plethora of unfavorable situations. In the following paper it is attempted to make wireless networks more easily secure by addressing one of the more commonly exploited technique of Rogue Access Points. This problem is tackled by articulating a method by which clients can recognize Access points to which they have previously connected. After a standard authentication procedure a packet exchange mechanism is used buttressed by a host of algorithms, selected randomly from an algorithm pool, which are run on selected packages on the client as well as the Access Point in order to completely obviate the possibility of a client connecting to a Rogue Access Point.
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