Patients with diabetic neuropathy (and other types of neuropathy) can develop a debilitating condition known as Charcot neuroarthropathy. In this condition the patient’s foot bones will become soft causing multiple bone fractures and bony destruction. The patient is typically unaware of this as it may not cause pain or symptoms that cue the patient into seeking help from his doctor immediately.  This process can happen multiple times causing large deformities of the foot most frequently a complete collalpse of the foot. This causes a rockerbottom foot appearance which can lead to ulcerations in the bottom of the foot. These ulcerations can be quite dangerous and lead to serious infections often affecting even the bones themselves. 

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Once the foot reaches this collapsed stage and develops a concerning ulceration the patient is at high risk of a limb-threatening infection. Our goal is to always avoid serious amputations and practice limb-salvage. In order to do this your surgeon will discuss a surgical procedure known as a Charcot Reconstruction in order to restore proper alignment of the foot by correcting the rocker bottom deformity. This procedure involves removing damaged bone and realigning the foot by way of multiple joint fusions.

 

A fusion is  medically known as an “arthrodesis”, during these procedures the joints are prepared and cut into in a specific way, any misalignments or deformities are corrected, and the positioning is held with a combination of screws, staples, or plates. Often during these cases the use of an External Fixator is implemented as well. External fixation involves placing metal rims surrounding the outside of your lower leg and foot with crossing  pins to hold the desired alignment and correction of the foot and ankle.