Hind foot Charcot deformity is a disastrous complication of diabetic neuropathy and can lead to instability, ulceration and major amputation. The treatment of these patients is controversial. Internal stabilization and/or external fixation have demonstrated variable results of limb salvage and some authorities thus advise patients to undergo elective major amputation. However, we report a series of 9 diabetic patients with severe hind foot deformity complicated by ulceration in 5/9, who underwent acute corrective internal fixation with successful correction of deformity, healing of ulceration in 4/5 patients and limb salvage in all cases. We treated 9 diabetic patients attending a multidisciplinary diabetic/orthopaedic foot clinic with progressive severe Charcot hind foot deformity despite treatment with total contact casting, 5 with predominant varus deformity and 2 with valgus deformity and 2 with unstable ankle joints. Five patients had developed secondary ulceration. All patients underwent corrective hind foot fusion with tibiotalo-calcaneal arthrodesis using a retrograde intra-medullary nail fixation and screws and bone grafting. One patient also with fixed plano-valgus deformity of the foot underwent a corrective mid-foot reconstruction.Introduction
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