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Charcot beaming

Roberto A Brandão, Jeffrey S Weber, David Larson, Mark A Prissel, Patrick E Bull, Gregory C Berlet, Christopher F Hyer
Surgical correction of complex foot and ankle deformities secondary to Charcot neuroarthropathy remains a significant surgical challenge. New technological advancements in hardware have allowed for the use of augmented fixation techniques in midfoot deformity correction, including the use of indication-specific locking plates and beaming techniques that offer enhanced stability. Severe hindfoot deformity management can employ the use of internal fixation, including intramedullary hindfoot nails and circular external fixation frames for limb salvage...
January 2018: Clinics in Podiatric Medicine and Surgery
Corey M Fidler, Benjamin C Watson, Christopher W Reb, Christopher F Hyer
In the modern treatment of Charcot neuroarthropathy, beam screw fixation is an alternative to plate and screw fixation. Exposure is minimized for implantation, and this technique supports the longitudinal columns of the foot as a rigid load-sharing construct. A published data review identified a paucity of data regarding metatarsal intramedullary canal morphology relevant to beam screw fixation. The purpose of the present study was to describe metatarsal diaphyseal morphology qualitatively and quantitatively in an effort to provide data that can be used by surgeons when selecting axially based intramedullary fixation...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Carroll P Jones
UNLABELLED: Charcot arthropathy commonly affects the midfoot and is often an extremely difficult and challenging surgical problem. Operative treatment with medial column arthrodesis using large intramedullary bolts or screws is an evolving and increasingly popular technique called "beaming." The technique is described here. LEVEL OF EVIDENCE: Level V, expert opinion.
July 2015: Foot & Ankle International
Kyle S Peterson, Christopher F Hyer
Charcot neuroarthropathy is frequently recognized as a major cause of morbidity in patients with neuropathic diabetes mellitus. Recently, intramedullary beam screw fixation has been used for midfoot Charcot reconstructions. Ten below-the-knee cadaveric specimens were used to demonstrate an antegrade, posterior approach for placement of a medial column beam screw, with specific attention to the proximity of the anatomic structures at risk. Six structures at risk were identified, including the sural nerve, ankle joint, flexor hallucis longus tendon, Achilles tendon, neurovascular bundle, and peroneal tendon sheath...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Benjamin D Cullen, Glenn M Weinraub, Gabriel Van Gompel
Charcot neuroarthropathy is a complicated condition affecting up to 1 in 680 diabetic patients that can rapidly cause severe destruction of the bony architecture in the foot, with resultant gross instability and frank deformity. Conservative care is not always successful at maintaining an intact soft tissue envelope of the foot; therefore, surgical reconstruction is often attempted in an effort to salvage the limb. The goal is to create a stable, plantigrade foot that can be placed in a shoe or simple brace...
March 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Paul K Commean, Jared A Kennedy, Karen A Bahow, Charles F Hildebolt, Lu Liu, Kirk E Smith, Mary K Hastings, Tao Ju, Fred W Prior, David R Sinacore
Diabetic foot diseases, such as ulcerations, infections, and neuropathic (Charcot's) arthropathy, are major complications of diabetes mellitus (DM) and peripheral neuropathy (PN) and may cause osteolysis (bone loss) in foot bones. The purposes of our study were to make computed tomography (CT) measurements of foot-bone volumes and densities and to determine measurement precision (percent coefficients of variation for root-mean-square standard deviations) and least significant changes (LSCs) in these percentages that could be considered biologically real with 95% confidence...
July 2011: Journal of Clinical Densitometry
William P Grant, Silvia Garcia-Lavin, Roy Sabo
This study explored the concept of "beaming" the medial and lateral longitudinal columns as a variation of the current technique for hindfoot and Lisfranc Charcot reconstruction. We reviewed radiographic changes and outcomes for patients who underwent Charcot foot reconstruction at our facility over the 14-year period from January 1994 to January 2008. Beaming was performed on 71 Charcot foot deformities in 70 patients, 22 (31%) of which displayed an isolated hindfoot deformity, 20 (28%) an isolated Lisfranc deformity, and 29 (41%) with a combination of hindfoot and Lisfranc deformities...
March 2011: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Mohammed Filali, Florence Dequen, Robert Lalonde, Jean-Pierre Julien
Charcot-Marie-Tooth (CMT) disease is the most frequently encountered hereditary disease causing sensorimotor neuropathies and slowly progressive muscle weakness and atrophy. The P22S mutation of the NEFL gene encoding the light polypeptide neurofilament (NFL) is associated with CMT. To understand more clearly the pathogenesis of sensorimotor dysfunction in CMT, we generated transgenic mice with the NEFL(P22S) mutation under the tet-off tetracycline regulated system with involvement of the Thy1 neuron-specific promoter...
June 1, 2011: Behavioural Brain Research
C Bibbo, S S Lin, H A Beam, F F Behrens
Ankle fracture in patients with DM mandates a stepwise protocol to minimize the potential complications of delayed fracture healing, wound complications, and development of Charcot arthropathy. For nondisplaced ankle fracture, a nonoperative approach with increased duration of immobilization seems successful based on experience of the limited series. A displaced ankle fracture in a patient with DM requires a surgical intervention. The authors advocate tight glucose control in both groups to improve the fracture milieu and to ameliorate the potential complications...
January 2001: Orthopedic Clinics of North America
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