Two Cases of Periprosthetic Fracture After Surgery for Acute Midfoot Charcot |
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| Affiliation: | 1. Surgeon, Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway;2. Surgeon, Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital Ullevål, Oslo, Norway;1. Program Director, Cleveland VA Podiatric Medicine and Surgery Residency, Reconstructive Rearfoot/Ankle Surgery, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH;2. Chief of Surgery, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio;3. Postgraduate Year 3, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH;1. Resident, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA;2. Staff Epidemiologist, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA;3. Professor, Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC;4. Assistant Professor, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA;1. Radiologist, Victoria House Medical Imaging, South Yarra, Victoria, Australia;2. Surgeon, Northern Health, Epping, Victoria, Australia;3. Surgeon, St Vincent''s Private Hospital East Melbourne, East Melbourne, Victoria, Australia;4. Radiographer, Victoria House Medical Imaging, South Yarra, Victoria, Australia;5. Anaesthetist, St Vincent''s Hospital Melbourne, Fitzroy, Victoria, Australia;6. Surgeon, Epworth Richmond Hospital, Richmond, Victoria, Australia;1. Resident, Atrium Health, Charlotte, NC;2. Attending Surgeon, OrthoCarolina Foot and Ankle Institute, Charlotte, NC;1. Research Fellow, National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK;2. Research Fellow, Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK;3. Medical Student, Barts and The London School of Medicine and Dentistry, London, UK;4. Reader, National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK;5. Reader, Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK;6. Professor, National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK;7. Professor, Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK |
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| Abstract: | Charcot neuroarthropathy is a rare condition that often results in deformity of the foot and ankle, with a high incidence of ulceration and a high risk of amputation. Traditionally, treatment of the acute stages of Charcot foot has been nonoperative until consolidation. Still, a large number of patients develop deformities, and early operative treatment of unstable Charcot feet has been suggested. To overcome some of the inherent challenges when operating on acute-stage Charcot feet, the superconstruct technique has been proposed. Early surgery for dislocated Charcot foot is sparingly described in the literature. To investigate the utility of the superconstruct technique for acute midfoot Charcot, we planned a prospective cohort study including patients with midfoot manifestation (Brodsky 1) in the active stages of the disease. Patients eligible for the study were treated with open surgery and midfoot arthrodesis using the superconstruct technique. In this report, we present the development of periprosthetic fractures related to early surgery using the superconstruct technique, possibly causing a more proximal Charcot manifestation in 2 patients with >24 months of follow-up. To our knowledge, such complications have been sparsely noted in the literature. |
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