Abstract
Charcot neuroarthropathy is a progressive, destructive process occurring in the presence of neuropathy. We report the outcome of neuropathic foot joints presenting to our clinic over a 12 year period.
Methods
Cases were identified from the Diabetic Foot Clinic Register, 1989–2001. We studied patient demographics, clinical presentation, distribution, treatment and outcome.
Results
Twenty-eight episodes of arthropathy occurred in 23 patients. Age at onset ranged from 40 to 79 years. Presentation was acute in 14 and subacute in the others. Sites affected included 23 mid foot, 4 ankle and 1 MTP. Nine feet were ulcerated at presentation, eight had a history of ulcer, nine have no ulcer history. Infection complicated the Charcot process in 15. Mean Hba1c at presentation was 9.3%.
Treatments
Total contact casting 23, 4 “scotch cast” boots and 1 Air-cast walker. Pamidronate was given to 10 patients.
Outcomes
Three patients died. Two had below knee amputations. Casts were required for up to 12 months. Three required orthopaedic foot reconstructions. All ulcers present initially healed.
Conclusion
Charcot arthropathy remains uncommon. In our series treatment was successful in all but two patients in terms of preserved limbs, mobility and freedom from ulceration.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
