Saturday, August 15, 2009


post operative xrays showing an intramedullary nail
(views from the side)

Intramedullary nail inserted from the heel to the tibia
(views from the front)

Side view of the ankle and foot
(normal alignment has been restored)

Views from the front
(The deformities prior to surgery has been corrected. The swelling of the joint has resolved)

The treatment of Charcot Arthropathy of the ankle is fraught with complications. Most of the modes of treatment is salvage by amputation. Various other methods of limb preservation surgery has been performed such as with external fixators and casting.

Problems associated with surgical intervention is the inability of the bone to unite and infection.

One mode of treatment which I perform for selected patients with this condition is called tibiotalocalcaneal fusion. This is performed by inserting a metal rod through the heel into the tibia in a retrograde fashion. This realigns the ankle and subtalar joint and provides a stable post which one can walk on.

There is lost of motion at the ankle and subtalar joint after the procedure as these joints are fused. Of all the patients who have had the surgery, all were happy with the outcome and function.

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