Charcot Reconstruction
Surgical Case Reports

To help you prepare the best surgical treatment for your Charcot cases we have compiled
a series of Charcot Reconstruction Case Reports, highlighting different clinical approaches
using internal and/or external fixation solutions.

 

It is up to the surgeon to take into consideration the patient's history and pathologic condition
before deciding on the most appropriate treatment option for each Charcot Foot case.

Internal Fixation

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

External Fixation

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Staged Approaches

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Internal Fixation

Internal fixation constructs include plating with locking screws, axial beaming with solid bolts and screws, and retrograde hindfoot intramedullary nailing. As a standalone construct, plating
is usually insufficient for Charcot foot reconstruction; super-constructs, which combine two or more devices, offer increased stability.

Learn how Philip Wrotslavsky, DPM FACFAS, Advanced Foot
and Ankle Center of San Diego, treated a 75 year-old diabetic
female patient using an internal beaming surgical approach.

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Download the Case Report to know how Gerard Cush,
MD (Danville, Pennsylvania) treated a 62 year-old male patient
with a history of diabetes, neuropathy, and rheumatoid arthritis,
using an intramedullary nail with Allograft.

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External Fixation

External fixation is especially useful in the presence of poor bone quality, ulceration, compromised soft tissue, active infection, or osteomyelitis, where the use of internal fixation is limited or contraindicated. Circular external fixation is the most described form of external fixation. Compared to monolateral external fixators, circular external fixators do not rely on the cortical fixation of half pins, which results in asymmetrical loading. Instead, they distribute forces circumferentially throughout the limb, enhancing stability, through transosseous wires.

Learn how Shrunjay R. Patel, DPM FACFAS, University
of North Carolina, Chapel Hill, NC addressed midfoot
deformity and non-healing wounds in a 29 year-old diabetic
Charcot patient using circular fixation.

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Please read our Privacy Policy before submitting this form

I have read and understood the Privacy Policy above and, therefore, I hereby consent to the processing of my personal data by Orthofix S.r.l.:

a) to allow Orthofix to carry out marketing initiatives described in point 3 (d) of the Privacy Policy, including for sending you marketing and promotional communications regarding Orthofix-branded products or services, or new initiatives and events.

b) for transmitting your personal data to third parties (namely to other Orthofix Group’s legal entities and to distributors engaged by them and Orthofix directly), in order to enable them to provide you with their own marketing and promotional communication.

Staged Approaches, Combining External
and Internal Fixation

Severe obesity, a need for increased mechanical stability and/or soft tissue protection, control of adjacent joint mobility, and a high risk for hardware failure are the main indications for a combined internal and external fixation approach, with staged procedures or superconstructs.

Download the Case Report by Lisa Grant-McDonald, DPM, Doctors Grant
Foot & Ankle, Virginia Beach to know how she managed reconstruction
of a Charcot midfoot fracture dislocation with a
two-stage approach utilizing circular fixation and intramedullary beams.

I have read and understood the Privacy Policy above and, therefore, I hereby consent to the processing of my personal data by Orthofix S.r.l.:

a) for sending me marketing and promotional communications regarding Orthofix-branded products or services, or new initiatives and events sponsored or organized by or on behalf of the Controller;

b) for transmitting my data to third parties (namely to other Orthofix Group’s legal entities and/or to distributors engaged by them or by Orthofix directly), in order to enable them to send me their own marketing and promotional communications regarding Orthofix-branded products or services and/or new initiatives and events sponsored or organized by them or on their behalf.

Learn how Philip Wrotslavsky, DPM FACFAS, Advanced Foot and Ankle Center of San Diego, managed a complicated Charcot foot deformity of a patient with previous left BKA, treated in two-stages with hexapodal system and beaming.

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Please read our Privacy Policy before submitting this form

Choose the Case Report/s you would like to download

I have read and understood the Privacy Policy above and, therefore, I hereby consent to the processing of my personal data by Orthofix S.r.l.:

a) to allow Orthofix to carry out marketing initiatives described in point 3 (d) of the Privacy Policy, including for sending you marketing and promotional communications regarding Orthofix-branded products or services, or new initiatives and events.

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When is time for a specialist?

Priority

Indications

Timeline

Follow-up

Priority

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Indications

  • Open wounds and deep ulcers
  • Pain at rest
  • Active Charcot Foot deformity
    (red, hot, swollen)
  • Vascular compromise

Timeline

  • Urgent/immediate referral
  • Patient needs interdisciplinary care
    management, off-loading with total
    contact cast devices and/or surgery,
    diabetic orthopedic footwear

Follow-up

  • According to specialist decision

Priority

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Indications

  • No sensitivity
  • Ulcers
  • Chronic vascular venous insufficiency
  • Previous lower limb amputation
    related to diabetes

Timeline

  • Immediate/first available referral
  • Patient needs diabetic orthopedic
    footwear, preventative off-loading
    and appropriate therapy

Follow-up

  • Every 1-2 months

Priority

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Indications

  • Insufficient sensitivity
  • No ulcers
  • Foot deformity
  • Posterior tibial pulse diminished
    or absent
  • Foot swelling, aedema

Timeline

  • No ulcers
  • Foot deformity
  • Posterior tibial pulse diminished
  • or absent
  • Foot swelling, edema
  • Referral within 3 weeks
  • Patient needs prescriptive footwear,
    preventative off-loading and
    appropriate therapy

Follow-up

  • Every 2-3 months

Priority

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Indications

  • Insufficient sensitivity
  • No ulcers
  • No foot deformity

Timeline

  • Referral within 1 months
  • Patient needs prescriptive footwear
    and preventive foot health behaviors
    education

Follow-up

  • Every 4-6 months

Priority

charcot neuropathy, Inbound C2 Charcot Reconstruction Surgical Case Reports

Indications

  • Satisfactory sensitivity
  • No ulcers
  • Possible foot deformity
  • No peripheral artery disease

Timeline

  • Referral within 3 months
  • Patient needs foot care and preventive
    foot health behaviors education

Follow-up

  • Once a year

Proper surgical procedure is the responsibility of the medical professional. This information is furnished as an informative guideline. Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience.

Review essential Charcot Reconstruction Tips, Tricks, and Pitfalls
from Charcot foot & ankle experts

Here

The following case reports show individual’s response to treatment. The information contained in these case reports is provided for informational and educational purposes. The case reports are not intended to guarantee the response other people may have to the treatment as responses to treatment can and due vary. Proper surgical procedure is the responsibility of the medical professional.
Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience.

Please visit Orthofix.com for more information on the devices shown on these case reports and their Instructions For Use.