Minimally Invasive Realignment Surgery for the Charcot Foot

  • Bradley M. Lamm
  • Dror Paley


The aftermath of Charcot, joint subluxation and loss of the bone quality, produces abnormal osseous prominences, which are potential areas for ulceration. Due to the deformed pedal position, the muscle-tendon balance is altered and the resultant aberrant weight-bearing forces increase the risk for ulceration. If ulcers are present, osteomyelitis can ensue, thus, if ulcers are present, they should be eradicated. The best treatment results are achieved when treatment is initiated during the early stages of Charcot neuroarthropathy.

The goal of treatment in the acute Charcot neuroarthropathy is to stabilize the condition. The traditional treatment is total contact casting for immobilizing. However, non-weight bearing in a total contact cast produces osteopenia of the ipsilateral foot and increased weight-bearing forces on the contralateral foot. These resulting sequelae can make it difficult for sequent surgery and can lead to ulceration and Charcot neuroarthropathy in the contralateral foot. Maintaining non-weight-bearing status is difficult for this patient population for multiple reasons (e.g., muscle atrophy, obesity, diminished proprioception).


External Fixation Deformity Correction Plantar Plating Taylor Spatial Frame Talar Neck 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



I thank Joy Marlowe, BSA, for her excellent illustrative artwork.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Rubin Institute for Advanced OrthopedicsSinai Hospital of BaltimoreBaltimoreUSA

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