Serial casting for reconstruction of a deformed Charcot foot: a case report.

INTRODUCTION: Charcot neuroarthropathy may occur in patients with peripheral neuropathy who do not notice pain while their bones and joints collapse or breakdown under the constant pressure of body weight. This can lead to ulcerations from severe deformity and potentially limb-threatening and life-threatening infections. Current treatments vary from immobilization to extensive reconstructive surgical interventions.

METHODS: Serial casting, used to correct many pediatric deformities while bones are often more pliable, was used with a 63-year-old male patient who presented with an active phase of Charcot foot with ulceration. The patient previously underwent foot reconstruction and had all hardware removed prior to serial casting. Due to the potential pliability of the bones, serial casting was attempted to reform the shape and position of the foot in a reverse Ponseti-type serial casting to create a more stable structure with less deformity that could lead to epithelial breakdown.

RESULTS: The patient regained full ambulation with a plantargrade foot and no wounds, and was followed without complications for 36 months.

CONCLUSION: Serial weekly casting was an effective modality for treatment of this patient's Charcot foot deformity.