Severe Charcot arthropathy

medial and lateral arthrodesis of the foot with intramedullary Bolt nails

Abstract

Charcot neuropathy is a syndrome characterized by fractures and luxations that occur with nonor minor trauma. It affects patients with peripheric neuropathy resulting from different conditions,the most common being the diabetes. We present the case of a male patient, 62 years old, witharterial hypertension, that comes to an appointment at our Orthopedic Hospital with the previousdiagnosis of Charcot arthropathy (etiology still unclear) with years of evolution, that had beenproposed to a foot amputation because of a severe structural deformity of the foot and recurrentplantar ulceration. Given the advanced stage, we proposed an arthrodesis of the medial and lateralcolumns of the foot (with intramedullary Bolt nails) and autologous bone graft form the iliac crest.With this surgical approach, it was possible to correct the foot deformity in “rocker bottom foot”,and a stable plantigrade foot was obtained. This way, there was scarring of the plantar ulcer andconsequent preservation of the affected limb. Functionally, there was a return to independence inactivities of daily living, and all the objectives proposed were achieved.