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Charcot reconstruction

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https://www.readbyqxmd.com/read/29799367/neuropathic-arthropathy-of-the-glenohumeral-joint-a-review-of-the-literature
#1
Lauren Santiesteban, Brent Mollon, Joseph D Zuckerman
Neuropathic arthropathy, also known as Charcot arthropathy, is a degenerative disorder most commonly characterized by rapid destruction of the joint with extensive involvement of the bone and soft tissue. The underlying pathophysiology is thought to be due to loss of nociception (pain sensation), most frequently caused by diabetes mellitus, syphilitic myelopathy, or syringomyelia. A neuropathic shoulder is rare, with historic case series forming the bulk of the literature. The purpose of this review is to better understand the pathogenesis, clinical presentation, and management of neuropathic arthropathy of the glenohumeral joint...
June 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29609479/improvement-in-quality-of-life-following-operative-correction-of-midtarsal-charcot-foot-deformity
#2
Ellen Kroin, Edwin O Chaharbakhshi, Adam Schiff, Michael S Pinzur
BACKGROUND: Patients with Charcot foot arthropathy report a poor quality of life following the development of deformity. Their quality of life is often not improved with "successful" historic accommodative treatment. There is increased current interest in operative correction of the acquired deformity with the stated goals of achieving both the traditional goals of resolution of infection and limb salvage as well as the desire to improve quality of life. The Short Musculoskeletal Functional Assessment (SMFA) outcomes instrument appears to be a valid tool for evaluating this complex patient population...
March 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29574036/prognostic-scoring-system-for-patients-undergoing-reconstructive-foot-and-ankle-surgery-for-charcot-neuroarthropathy-the-charcot-reconstruction-preoperative-prognostic-score
#3
David Rettedal, Alissa Parker, Adam Popchak, Patrick R Burns
Charcot neuroarthropathy is a destructive process that occurs in patients with peripheral neuropathy, often due to poorly controlled diabetes mellitus. Surgical reconstruction can be necessary to provide a plantigrade foot that is wound free. A risk of major amputation exists after a Charcot event and after attempted reconstruction. We retrospectively reviewed the data from 34 patients (36 reconstructions) who had undergone reconstructive surgery for Charcot neuroarthropathy. The mean patient age was 56.44 years...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29504150/reconstruction-of-diabetic-lower-leg-and-foot-soft-tissue-defects-using-thoracodorsal-artery-perforator-chimeric-flaps
#4
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
https://www.readbyqxmd.com/read/29437061/mid-term-follow-up-of-patients-with-hindfoot-arthrodesis-with-retrograde-compression-intramedullary-nail-in-charcot-neuroarthropathy-of-the-hindfoot
#5
M Chraim, S Krenn, H M Alrabai, H-J Trnka, P Bock
AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29227787/major-destructive-asymptomatic-lumbar-charcot-lesion-treated-with-three-column-resection-and-short-segment-reconstruction-case-report-treatment-strategy-and-review-of-literature
#6
Kestutis Valancius, Gaurav Garg, Madalina Duicu, Ebbe Stender Hansen, Cody Bunger
Charcot's spine is a long-term complication of spinal cord injury. The lesion is often localized at the caudal end of long fusion constructs and distal to the level of paraplegia. However, cases are rare and the literature relevant to the management of Charcot's arthropathy is limited. This paper reviews the clinical features, diagnosis, and surgical management of post-traumatic spinal neuroarthropathy in the current literature. We present a rare case of adjacent level Charcot's lesion of the lumbar spine in a paraplegic patient, primarily treated for traumatic spinal cord lesion 39 years before current surgery...
2017: SICOT-J
https://www.readbyqxmd.com/read/29172758/deformity-and-clinical-outcomes-following-operative-correction-of-charcot-foot-a-new-classification-with-implications-for-treatment
#7
Michael S Pinzur, Adam P Schiff
BACKGROUND: The historic treatment of Charcot foot arthropathy has been immobilization during the active phase of the disease process, followed by accommodative bracing of the acquired deformity. Evidence derived from modern patient-reported outcomes investigations has convinced many surgeons to attempt operative correction of the acquired deformity with a goal of improving quality of life. METHODS: Over a 12-year period, 214 patients (9 bilateral) underwent reconstruction of the acquired deformity associated with midtarsal Charcot foot arthropathy...
March 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29096337/viability-of-permanent-pmma-spacer-with-combined-free-fasciocutaneous-tissue-transfer-for-failed-charcot-reconstruction-a-38-month-prospective-case-report
#8
Tammer Elmarsafi, John S Steinberg, Paul J Kim, Christopher E Attinger, Karen K Evans
INTRODUCTION: Charcot Neuroarthropathy is a complex lower extremity pathology which predisposes the afflicted limb to ulcerations, osteomyelitis, and risk of major amputation. Charcot Neuroarthropathy often requires osseous reconstruction, which can be complicated with osteomyelitis and hardware infection. When soft tissue and osseous deficits must be concomitantly addressed, the use of PMMA spacers can be combined with free tissue transfers. PRESENTATION OF CASE: 71year old Caucasian male with Diabetic Charcot Neuroarthopathy underwent osseous reconstruction with internal hardware...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28633781/beaming-in-charcot-arthropathy-intramedullary-fixation-for-complicated-reconstructions-a-cadaveric-study
#9
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
https://www.readbyqxmd.com/read/28222170/biomechanical-investigation-of-two-plating-systems-for-medial-column-fusion-in-foot
#10
Paul Simons, Theresia Sommerer, Ivan Zderic, Dieter Wahl, Mark Lenz, Hristo Skulev, Matthias Knobe, Boyko Gueorguiev, R Geoff Richards, Kajetan Klos
BACKGROUND: Arthrodesis of the medial column (navicular, cuneiform I and metatarsal I) is performed for reasons such as Charcot arthropathy, arthritis, posttraumatic reconstruction or severe pes planus. However, the complication rate is still high and mainly resulting from inadequate fixation. Special plates, designed for medial column arthrodesis, seem to offer potential to reduce the complication rate. The aim of this study was to investigate biomechanically plantar and dorsomedial fusion of the medial column using two new plating systems...
2017: PloS One
https://www.readbyqxmd.com/read/28033054/staged-reconstruction-for-acute-charcot-s-subtalar-joint-dislocationa-case-report
#11
Spencer Monaco, Patrick Burns, Alissa Toth
Charcot's neuroarthropathy can have devastating consequences if left untreated or misdiagnosed. With progression of the disease from the acute to the chronic phase, substantial deformity and instability may result, leading to ulceration and a nonfunctional limb. The purpose of this case report is to present a staged reconstruction for active Charcot's neuroarthropathy involving the subtalar joint with complete dislocation that resulted in limb salvage and maintenance of limb function at 1-year follow-up. Although for many patients the mainstay of treatment for early Charcot's neuroarthropathy is conservative care with off-loading, early surgical correction that includes external fixation followed by definitive arthrodesis for select patients may be warranted...
November 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28031030/outcome-after-protected-full-weightbearing-treatment-in-an-orthopedic-device-in-diabetic-neuropathic-arthropathy-charcot-arthropathy-a-comparison-of-unilaterally-and-bilaterally-affected-patients
#12
COMPARATIVE STUDY
Niklas Renner, Stephan Hermann Wirth, Georg Osterhoff, Thomas Böni, Martin Berli
BACKGROUND: Charcot neuropathic arthropathy (CN) is a chronic, progressive, destructive, non-infectious process that most frequently affects the bone architecture of the foot in patients with sensory neuropathy. We evaluated the outcome of protected weightbearing treatment of CN in unilaterally and bilaterally affected patients and secondarily compared outcomes in protected versus unprotected weightbearing treatment. METHODS: Patient records and radiographs from 2002 to 2012 were retrospectively analyzed...
December 29, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28030964/charcot-collapse-does-collapse-pattern-dictate-osseous-metabolism
#13
Lisa Grant, Robert Yoho, Chandana Halaharvi, William Grant
Charcot fracture pattern (FP) and Charcot dislocation pattern (DP) are 2 distinct collapse patterns identified in Charcot neuroarthropathy of the foot and ankle. These patterns are believed to demonstrate relative differences in central bone mineral density (BMD), which has been theoretically extrapolated to describe local BMD. To assess variation in local bone composition of FP and DP patients, 10 patients, 5 DP and 5 FP were recruited. The patient's age, body mass index (BMI), radiographs, central BMD, local BMD, sRANKL (soluble receptor activator nuclear factor kappa-beta ligand), sRAGE (soluble receptors of advanced glycated end-products), and osteocalcin were measured to determined bone metabolic status and density...
October 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27923212/comparison-of-diabetic-charcot-patients-with-and-without-foot-wounds
#14
COMPARATIVE STUDY
Dane K Wukich, David Sadoskas, Nicholas J Vaudreuil, Mitchell Fourman
BACKGROUND: The primary aim of this study was to evaluate the outcomes of a series of patients with Charcot neuroarthropathy (CN) who were evaluated in a tertiary care setting. We hypothesized that those patients with CN who presented with a Charcot-related foot wound would have lower rates of successful limb salvage than patients who presented without a wound. METHODS: Two hundred forty-five patients (280 feet) were identified with diabetic CN during the time period from January 1, 2005, to June 1, 2015...
February 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#15
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865317/revisional-surgery-of-the-diabetic-charcot-foot-and-ankle
#16
REVIEW
Patrick R Burns, Spencer J Monaco
Charcot neuroarthropathy (CN) is a difficult problem for the foot and ankle surgeon. If surgery is required, little is known or available regarding the best methods and timing. When the initial attempt of reconstruction fails, revision of CN is even more demanding. One must take in to account all aspects, including nutrition, vascular status, infection control, short- and long-term blood glucose management, as well as other factors requiring laboratory monitoring and consult services. Once optimized, the biomechanics of the deformity can be addressed and decisions can be made on fixation devices...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#17
REVIEW
Claire M Capobianco, Thomas Zgonis
Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#18
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27534088/-clinical-observation-on-plate-on-the-metatarsal-side-to-reconstruction-of-tarsometatarsal-joint-dislocations-secondary-to-diabetic-charcot-foot
#19
Hai-bo Zhou, Chao Zhang, Cai-long Liu, Lei Chen
OBJECTIVE: To evaluate clinical results of plate on the metatarsal side to reconstruction of tarsometatarsal joint dislocations secondary to diabetic charcot foot. METHODS: Seven patients (9 feet) patients with tarsometatarsal joint dislocations secondary to diabetic charcot foot were treated with plating from April 2012 to December 2014. All patients were male, and 5 cases were on the unilateral side and 2 cases were on the bilateral sides. The age of patients ranged from 45 to 52 with an average of 48 years old...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27392451/-internal-circular-arc-osteosynthesis-of-tibiotalocalcaneal-arthrodesis
#20
Kaj Klaue, H Zwipp, T Mittlmeier, N Espinosa
Tibiotalocalcaneal arthrodesis has recently become more popular as a form of reconstructive surgery. The precise anatomical orientation and the functional extrinsic musculature of the hindfoot are essential for a satisfactory result. Fixation of the arthrodesis is a mechanical problem. Straight and angulated nails are not anatomically or mechanically ideal. A circular arc nail can fix the tibia, the talus and the calcaneus in anatomical alignment. This is a pure "bone nail", in contrast to the "intramedullary nail," which is driven through an existing opening in long bones...
October 2016: Der Unfallchirurg
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