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. 2021 Feb 23:16:277-284.
doi: 10.1016/j.jcot.2021.02.007. eCollection 2021 May.

Charcot hindfoot deformity reconstruction using a hindfoot nail- surgical technique

Venu Kavarthapu  1   2 , Thomas Hester  1
Affiliations

Charcot hindfoot deformity reconstruction using a hindfoot nail- surgical technique

Venu Kavarthapu et al. J Clin Orthop Trauma. .

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Jul 30;20:101539. doi: 10.1016/j.jcot.2021.101539. eCollection 2021 Sep. J Clin Orthop Trauma. 2021. PMID: 34405084 Free PMC article.

Abstract

Various techniques of reconstruction of deformed Charcot hindfoot using different internal fixation devices have been described in the literature. We present our surgical technique using specific principles that has resulted in improved outcomes to allow correction of deformity, obtain stability and allow progression to weightbearing in orthotic shoes. We describe our preoperative evaluation, planning and surgical timing. We also hope to share some technical pearls and details on the finer points to achieve a satisfactory correction and reduce the learning curve.

Keywords: Charcot; Hindfoot; Neuropathic deformity; Reconstruction.

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Figures

Fig. 1A and b
Fig. 1A and b
3D printed model used for pre and intraoperative planning.
Fig. 2
Fig. 2
Trans-lateral malleolar approach to access the ankle and subtalar joints, emphasising full thickness soft tissue flaps.
Fig. 3
Fig. 3
Limited dorsomedial approach over the medial ankle gutter used for the preparation of the medial gutter and to perform any soft tissue releases on the medial side of the ankle.
Fig. 4
Fig. 4
The talar articular surface in the ankle and medial gutter is cut, and bone wedges are included to correct the deformity and achieve optimal bone opposition.
Fig. 5A and b
Fig. 5A and b
Distal locking screws into calcaneus and talar fragments are inserted to lock the nail in compression.
Fig. 6A and b
Fig. 6A and b
A standard hindfoot nail construct with a separate cannulated partially threaded screw inserted from calcaneum into distal tibia to add rotational stability and added compression.
Fig. 7A and b
Fig. 7A and b
For severe deformity another option of achieving additional rotational rigidity is to use a locking plate across distal tibia and talar body anteromedially.
See this image and copyright information in PMC

References

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    1. Ha J., Hester T., Foley R. Charcot foot reconstruction outcomes: a systematic review. J Clin Orthop Trauma. 2020 May-Jun;11(3):357–368. doi: 10.1016/j.jcot.2020.03.025. Epub 2020 Apr 20. - DOI - PMC - PubMed
    1. Kavarthapu V. Surgical management: internal stabilisation. In: Edmonds M., Sumpio B., editors. Limb Salvage of the Diabetic Foot- an Interdisciplinary Approach. Springer; 2019. pp. 173–184.
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