August 2017

Charcot expert underscores midtarsal correction risks as well as successes

In the moment: Diabetes

By Jordana Bieze Foster

Surgical correction of midtarsal deformities related to Charcot neuroarthropathy can have a high success rate, but patient comorbidities should be carefully considered, according to research presented in July at the annual meeting of the American Orthopaedic Foot & Ankle Society in Seattle.

Researchers analyzed 214 patients over a 12-year period, all of whom were immobilized postoperatively with an external fixator. Clinical success, based on resolution of infection and the ability to resume independent walking with commercially available therapeutic footwear, was achieved in 89.6% of feet with a valgus deformity and 58.7% of feet with a varus deformity.

But the seven deaths and 15 amputations seen within one year of surgery are noteworthy, said Michael Pinzur, MD, a professor of orthopedic surgery at Loyola University Medical Center in Maywood, IL, who presented the findings.

“This is deserving of consideration if we’re going to subject this highly comorbid population to the rigors of surgery,” Pinzur said. “These people are all vitamin D deficient, they are all osteopathic, and they have poor bone quality.”

Source:

Pinzur M, Schiff A. Deformity and clinical outcomes following surgical correction of Charcot foot. Presented at the American Orthopaedic Foot & Ankle Society Annual Meeting, Seattle, WA, July 2017.

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