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Charcot Foot: Surgical Management and Reconstruction

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Functional Limb Salvage

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Abstract

The surgical management of Charcot neuroarthropathy has undergone a paradigm shift over the past several decades. Historically, reconstructive surgery for Charcot neuroarthropathy was reserved for only most severe cases as a final attempt to avoid major amputation. The timing of surgical intervention and types of reconstructive surgery were often the subject of great debate because of high complication rates. With the advent of new forms of fixation and better understanding of the pathophysiology, successful limb salvage rates of 80–95% are realistic. Charcot neuroarthropathy of the foot and ankle is a spectrum of injury that ranges from fractures, dislocations, and fracture dislocations in patients with compromised bone and peripheral neuropathy. Once deformity develops, the risk of ulceration, infection, and amputation rises significantly. To reduce the rate of major amputation in patients with Charcot neuroarthropathy, the rate of soft tissue and bone infections needs to be reduced. Infections occur secondary to foot ulcers, and ulcers develop from osseous deformity in patients with insensate feet. Surgical realignment of Charcot deformity prior to ulceration has a high rate of success in avoiding infection and amputation. Restoring a plantigrade foot in these compromised patients can facilitate mobility and improve health-related quality of life.

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Author information

Authors and Affiliations

  1. Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Dane K. Wukich

  2. Odense University Hospital, University of Southern Denmark, Odense, Denmark

    Venu Kavarthapu

  3. King’s College Hospital, London, UK

    Venu Kavarthapu

Authors
  1. Dane K. Wukich
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  2. Venu Kavarthapu
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Correspondence to Dane K. Wukich .

Editor information

Editors and Affiliations

  1. Department of Plastic Surgery, Georgetown University School of Medicine and MedStar Georgetown University Hospital, Washington, DC, USA

    Christopher E. Attinger

  2. Department of Plastic Surgery, Georgetown University School of Medicine and MedStar Georgetown University Hospital, Washington, DC, USA

    John S. Steinberg

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Wukich, D.K., Kavarthapu, V. (2023). Charcot Foot: Surgical Management and Reconstruction. In: Attinger, C.E., Steinberg, J.S. (eds) Functional Limb Salvage. Springer, Cham. https://doi.org/10.1007/978-3-031-27725-2_19

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  • DOI: https://doi.org/10.1007/978-3-031-27725-2_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-27724-5

  • Online ISBN: 978-3-031-27725-2

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