CME OnDemand: 2022 AOFAS Annual Meeting-Combined Internal and External Fixation for Charcot Neuro Arthropathy: 1 Year Results

Pdf Summary

The study evaluated the effectiveness of combined internal and external fixation for the treatment of Charcot neuroarthropathy in complex foot and ankle deformities. The advantages of this method include fusion into normal bone, reliable deformity correction, early weight bearing, reduced sarcopenia, and limb preservation. The aim of the study was to assess limb preservation rate, deformity correction rate, and complication rate. <br /><br />The study included 18 cases, with 17 of them having primary pathology of T2DM. The fixation method used was internal fixation in 3 cases, external fixation in 5 cases, and combined internal and external fixation in 10 cases. <br /><br />The results showed a limb salvage rate of 94% and a mortality rate of 0%. All patients were able to ambulate, were ulcer-free, had improved pain, and were fused at 1 year. The average time to fusion was 154 days, ranging from 360 to 52 days. There were no recurrent ulceration or recurrent infections reported.<br /><br />The study also found that Mearys angle improved in all groups, with the combined group showing the most improvement. Complications such as tibial fractures, metalwork removal, and delayed wound healing were noted in the first three patients.<br /><br />The study concluded that combined internal and external fixation for Charcot neuroarthropathy is safe and achieves good results. Patients can be successfully mobilized without compromising the achieved correction. However, there is a learning curve associated with this technique, and complications reported in the first three patients should be noted. Cases with external fixation only may benefit from delayed internal fixation to maintain correction.

Asset Subtitle

Muhammed H. Iqbal, MD, Sultan N. Qasim, FRCS(Tr&Orth), Simon Chambers, FRCS

Keywords

Charcot neuroarthropathy

foot and ankle deformities

combined internal and external fixation

fusion into normal bone

deformity correction

early weight bearing

reduced sarcopenia

limb preservation

limb preservation rate

deformity correction rate