Intramedullary Compressive Nail Fixation for the Treatment of Severe Charcot Deformity of the Ankle and Rear Foot
| Autor: | Sebastiano Caruso, Carlo Caravaggi, Sergio Dalla Noce, Marzio Cimmino |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Joint Instability
Male musculoskeletal diseases medicine.medical_specialty Heel Arthrodesis medicine.medical_treatment Bone Nails law.invention Intramedullary rod law Arthropathy Deformity medicine Humans Orthopedics and Sports Medicine Mobility Limitation business.industry Middle Aged Limb Salvage medicine.disease Malleolus Diabetic Foot Surgery Treatment Outcome medicine.anatomical_structure Amputation Female Arthropathy Neurogenic medicine.symptom Ankle business Ankle Joint Follow-Up Studies |
| Zdroj: | The Journal of Foot and Ankle Surgery. 45:20-24 |
| ISSN: | 1067-2516 |
| DOI: | 10.1053/j.jfas.2005.10.003 |
| Popis: | Involvement of the ankle joint in Charcot osteoarthropathy may be associated with severe instability and fracture or collapse of the talus. Recalcitrant ulceration may result over the lateral malleolus, increasing the risk of major amputation. This study evaluated ankle arthrodesis with a compressive intramedullary nail in 14 patients with diabetes affected by Charcot of the ankle. The mean patient age was 58 +/- 12 years, and the mean duration of diabetes was 17 +/- 5 years. Transcutaneous oxygen pressures wereor = 50 mm Hg in all patients, indicating a good distal blood supply. A below-knee amputation had previously been suggested because of severe ankle joint instability. None of the patients were able to walk without a brace. Four patients had an ulceration that had healed before the index procedure. All procedures were performed in the quiescent phase of the disease. After a mean follow-up of 18 +/- 4 months, 10 patients (71.4%) achieved a solid arthrodesis, returning to walking with protective shoes. Three patients (21.4%) developed breakage of the calcaneus screws, necessitating removal of the screws in 2 cases and removal of the entire nail in 2 cases. These 3 patients went on to fibrous union that allowed walking with a brace. One patient (7.2%) required a below-knee amputation because of postoperative osteomyelitis of the distal tibia. The data from our study demonstrate a high rate of limb salvage (92.8%), suggesting that this device is safe and effective in the treatment of Charcot arthropathy of the ankle. |
| Databáze: | OpenAIRE |
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