One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis.
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Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period.
Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy.
Comparative Analysis of Three Types of Therapeutic Offloading Diabetic Shoes With Custom Made Insole on Plantar Pressure Distribution in Severe Diabetic Charcot Foot.
Can Prosthet Orthot J
August 2024
Department of Rehabilitation Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Article Synopsis
- - The study investigates the effects of three types of therapeutic offloading diabetic shoes (prefabricated, relasting, and double rocker-modified) on peak plantar pressure in individuals with Charcot foot deformity, a complication of diabetes involving neuropathy.
- - Involving 15 participants with Charcot neuropathy, the research measures plantar pressure during walking to assess how different shoes impact pressure distribution in the forefoot, midfoot, and hindfoot.
- - Results show that while the double rocker-modified shoe increased forefoot pressure slightly, it significantly reduced midfoot pressure compared to other shoes, indicating varied effects on plantar pressure distribution.
Factors associated with the development of recurrent and contralateral Charcot neuroarthropathy in individuals with diabetes mellitus: A scoping review.
J Foot Ankle Res
December 2024
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Introduction: Charcot neuroarthropathy (CN) can result in fractures and dislocations of the foot and ankle in individuals with diabetes and neuropathy, leading to ulceration, amputation and a poor quality of life. Additional episodes of acute CN can lead to extended periods of physical and psychosocial distress. The aim of this scoping review was to identify and synthesise the evidence relating to factors associated with the development of recurrent and contralateral Charcot neuroarthropathy (CN) in individuals with diabetes.
View Article and Find Full Text PDFWhere Minimal Incision Surgery Can Have Maximum Results with Charcot Reconstruction.
Clin Podiatr Med Surg
January 2025
International Center of Limb Lengthening, Rubin Institute of Advanced Orthopedics, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA; Division Of Podiatric Surgery, Sinai Hospital, Baltimore, MD, USA. Electronic address:
Minimally invasive surgery (MIS) continues to develop as a viable alternative to traditional open surgery for various foot and ankle pathologies. The neuropathic foot is one area where MIS can be very beneficial to surgeons and their patients. Improving wound healing and decreasing the surgical footprint and thus reducing complications associated with soft tissue in this population is advantageous.
View Article and Find Full Text PDFApproach to Charcot Neuroarthropathy of the Great Toe: A Case Report.
Cureus
October 2024
Orthopaedics, Dr. D.Y.Patil Medical College, Hospital and Research Centre, Dr. D.Y.Patil Vidyapeeth (Deemed to be University), Pune, IND.
Charcot neuroarthropathy (CN) is a chronic progressive debilitating disease affecting joints, bone and soft tissue of an insensate limb, usually seen in patients with diabetes. CN of the great toe is rare or it may be associated with CN of other joints. Only a few cases have been reported on the CN of the great toe.
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