The use of circular frame external fixation in the treatment of ankle/hindfoot Charcot Neuroarthropathy |
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| Affiliation: | 1. Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK;2. Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi 110001, India;3. Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India;4. Nuclear Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK;1. University of Miami Miller School of Medicine, 1600, NW 10th Ave #1140, Miami, FL, USA;2. University of Miami Miller School of Medicine, Department of Orthopaedics, 1600, NW 10th Ave, Miami, FL, USA;1. Clinical Fellow, Mumbai Institute of Spine Surgery, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, 400020, India;2. Head- Mumbai Institute of Spine Surgery, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, 400020, India;1. Ghaem Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran;2. Statistics Department, School of Health, Guilan University of Medical Sciences, Rasht, Iran;3. General Practitioner, Guilan University of Medical Sciences, Rasht, Iran;4. Department of Anatomical Sciences & Cell Biology, Mashhad University of Medical Sciences, Mashhad, Iran |
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| Abstract: | Charcot Neuroarthropathy (CN) of the ankle/hindfoot is a devastating condition that results in a loss of alignment, bony malleolar protrusions and frequently leads to ulceration, infection, and amputation. Major limb amputations in this patient population has a 5-year mortality rate approximating 39%–68%. The treatment goal for CN of the ankle/hindfoot is to provide stability with a plantigrade foot that is infection free, shoeable and allows independent weight bearing. The use of a circular frame external fixator is often required when treating patients with CN of the ankle/hindfoot because they often present late with deformity, soft tissue compromise and infection which are contraindications to primary internal fixation. These patients require urgent surgical attention to salvage the limb or risk amputation. In this narrative review article we will discuss the indications, management options, surgical technique, evidence and describe our experience in the use of circular frame external fixation in patients with ankle/hindfoot Charcot Neuroarthropathy. |
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| Keywords: | Charcot neuroarthropathy Hindfoot Ankle Circular frame external fixator Limb salvage |
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