Orthotic Management of Charcot Feet After External Fixation Surgery

Koller, A.; Meißner, Stefan; Podella, Maike; Fiedler, R.

doi:10.1016/j.cpm.2007.03.012

Cited by 15 publications

(4 citation statements)

References 19 publications

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“…La idea de fondo al tratar estos pacientes es prácticamente "doblar" todos los aspectos de la cirugía con respecto a un paciente no diabético para protegerlo lo más posible, por lo que se utiliza más material de osteosíntesis y se inmoviliza durante más tiempo. Posterior a las 12 semanas de descarga, el paciente comenzó a utilizar una bota tipo Walker durante un mes y posteriormente una férula AFO 39 al ser un aparato efi-ciente y cómodo para el tratamiento ortésico después de la cirugía reconstructiva 40 , que aún sigue utilizando, teniendo como propósito evitar que el trauma de la intervención pueda provocar otro proceso de neuroartropatía de Charcot 1,14 . Esta férula AFO ayuda a proporcionar un reparto de cargas más homogéneo 41,42 y una protección mayor para que el paciente desarrolle su actividad diaria y laboral 33,43 .…”

Section: Discussionunclassified

Reconstrucción quirúrgica de un caso clínico complejo de neuroartropatía de Charcot

Pérez¹,

Cicchinelli²,

Huerta³

et al. 2020

Rev. Esp. Pod.

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La neuroartropatía de Charcot es reconocida como una enfermedad destructiva, progresiva y no infecciosa de origen multifactorial en pacientes con diabetes mellitus como principal causa etiológica. Esta destrucción puede ser a diferentes niveles del pie. El presente artículo presenta un caso clínico de un paciente que sufre una deformidad severa rígida en pie varo secundario a neuroartropatía de Charcot tipo II (según clasificación Sanders & Frykberg) en fase 2 (según clasificación de Eichenholtz) cuya solución de tratamiento propuesto era amputación infracondílea. Se realizó una reconstrucción quirúrgica de la deformidad consistente en alargamiento percutáneo del tendón de Aquiles, tenotomía del tibial posterior, fusión de la columna interna y externa con estabilización mediante placas de bloqueo; también se realizó fusión de la articulación subastragalina y trasposición del extensor común de los dedos y tibial anterior a la base del cuarto metatarsiano. El resultado del caso fue muy bueno y la evolución al año permitió al paciente incorporarse a su actividad diaria. Este artículo pretende mostrar una opción de tratamiento para este tipo de patología con buenos resultados y mostrando una posibilidad de solución a estos pacientes, evitando así la amputación del miembro.

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Section: Discussionunclassified

Reconstrucción quirúrgica de un caso clínico complejo de neuroartropatía de Charcot

Pérez¹,

Cicchinelli²,

Huerta³

et al. 2020

Rev. Esp. Pod.

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“…Some 6–8 weeks after surgery they are again admitted to hospital, and the external fixator is removed and a cast is applied. Mean casting time is ~ 10 days, during which time fitting of a custom‐made carbon ankle foot orthosis 7 is done as an inpatient procedure for rehabilitation. This procedure allows early ambulation in the custom‐made orthosis with full weight‐bearing.…”

Section: Participants and Methodsmentioning

confidence: 99%

Long‐term outcome of persons with diabetic and non‐diabetic neuro‐osteoarthropathy after foot correction using external fixation

et al. 2020

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Aim Diabetic neuro‐osteoarthropathy (Charcot foot) is a serious form of diabetic foot syndrome, often leading to severe deformity of the foot and subsequently to ulcers and osteomyelitis. The aim of this retrospective study was to determine the success rate and long‐term outcomes for a Charcot foot operation using external fixation in 115 individuals who underwent surgery between July 2008 and December 2012. Methods Some 115 consecutive persons, 78 (68%) men and 37 (32%) women, were enrolled in this study. The eligibility criterion for this retrospective study was reconstructive foot surgery using a Hoffmann II external fixator in diabetic and non‐diabetic neuro‐osteoarthropathy. The main examination parameters in the follow‐up were walking ability, amputation and mortality. Average follow‐up was 5.7 (± 3.2) years. Results Ninety‐seven per cent of people were able to walk after the operation with bespoke shoes or an orthosis. At follow‐up, 77% were able to walk and 51% were fully mobile even outside the home. Subsequent amputations were performed in 29 individuals (26%), with 17 (15%) minor and 12 (11%) major amputations. Forty‐seven individuals died before follow‐up, the majority (53%) from cardiovascular events. Average survival time post surgery was 4.5 (± 2.9) years. Conclusion Reconstruction surgery using external fixation is a very useful method for maintaining walking ability in the case of conservatively non‐treatable diabetic and non‐diabetic neuro‐osteoarthropathy. Individuals with severe Charcot foot disease had a low rate of major amputations. Osteomyelitis was the main reason for major amputations.

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“…The CROW was initially developed for use in Stage I CN; however, more recently it is also proving useful in Stage 3 to maintain foot and ankle alignment. Koller et al (9) advocate the CROW for patients following surgical reconstruction, specifically after external fixation procedures. It is important to note that design and efficacy of the removable walker device relies heavily on patient compliance.…”

Section: Immobilization and Mechanical Protectionmentioning

confidence: 99%

An overview of conservative treatment options for diabetic Charcot foot neuroarthropathy

Ramanujam

Facaros

2011

Diabetic Foot & Ankle

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Conservative management of Charcot foot neuroarthropathy remains efficacious for certain clinical scenarios. Treatment of the patient should take into account the stage of the Charcot neuroarthopathy, site(s) of involvement, presence or absence of ulceration, presence or absence of infection, overall medical status, and level of compliance. The authors present an overview of evidence-based non-operative treatment for diabetic Charcot neuroarthropathy with an emphasis on the most recent developments in therapy.

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Orthotic Management of Charcot Feet After External Fixation Surgery

Cited by 15 publications

References 19 publications

Reconstrucción quirúrgica de un caso clínico complejo de neuroartropatía de Charcot

Reconstrucción quirúrgica de un caso clínico complejo de neuroartropatía de Charcot

Long‐term outcome of persons with diabetic and non‐diabetic neuro‐osteoarthropathy after foot correction using external fixation

An overview of conservative treatment options for diabetic Charcot foot neuroarthropathy

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