Charcot Reconstruction with External Fixation

Many patients with Charcot neuropathy develop a malaligned foot position. Deformity of the foot, instability, osteomyelitis, and ulceration are all common indications for Charcot reconstruction surgery. External fixation should always be considered when osteomyelitis has been previously diagnosed. Presented is a case of a 52 year old diabetic male with an unstable Lisfranc and Charcot midtarsal joint of the right foot who underwent external fixation correction. A two-stage gradual technique was utilized. First gradual distraction of the forefoot on a fixated hindfoot provides anatomical realignment of the foot. The second stage is a formal minimally invasive fusion of the Charcot joints with either intramedullary foot fixation or external fixation compression. This two-stage gradual technique creates a stable plantigrade foot.