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What is Charcot Reconstruction?

Charcot foot and ankle is a condition characterized by gradual weakening of the bones, joints and soft tissues, and loss of sensation in the foot and ankle. It is caused by nerve damage (neuropathy) in the foot and ankle or due to diabetes.

Charcot reconstruction is the surgical procedure of repairing and restoring the foot and ankle.

Indications for Charcot Reconstruction

Notable indications for Charcot reconstruction can be:

  • Redness and swelling of the foot and ankle
  • Warmth or hot to the touch
  • Limited mobility, loss of firmness
  • Twisted and unsteady ankle
  • Development of hard to heal pressure sores
  • Fractures or dislocations of bones and joints
  • Deformed foot shape, curly toes
  • Bones pressing against your shoes
  • Skin ulcers, bone infection (osteomyelitis)

How do you Prepare for the Procedure?

Your surgeon is likely to order preoperative screening to assess your medical condition.

Subsequently, you may be instructed to:

  • Avoid certain medications (if applicable)
  • Stop or reduce smoking (if applicable)
  • Fast for a specific period before surgery
  • Arrange for transportation after surgery

How is Charcot Reconstruction Performed?

Charcot reconstruction is performed under general anesthesia and may include cutting and realignment of the foot and ankle bones (osteotomy) and fusion (correction of deformity). Your surgeon utilizes intraoperative fluoroscopy to ensure precise reconstruction.

During the procedure:

  • Small incisions are made around your foot and ankle joint.
  • The arthroscope and special instruments are inserted into the joint.
  • The bones are shortened or lengthened as needed to alter their alignment.
  • Bones are shortened by cutting or lengthened by adding a wedge of bone.
  • The bones are then fixed with metal plates or screws.
  • Screws or plates may even be placed across normal joints to provide added stability.
  • The incisions are closed by sutures and protected with skin tape or a dressing pad.

The reconstruction is secured with an external fixator outside the leg to prevent movement of the foot and ankle until functioning capacity is regained.

Risks Associated with the Procedure

The possible risks associated with the procedure include but are not limited to:

  • Superficial and/or deep infection
  • Wound complications
  • Foot and ankle instability
  • Hardware failure

What Precautions Should be Taken as You Recover from the Procedure?

As you recover, your surgeon may expect you to do the following:

  • Complete bed rest initially for a few days
  • Strict non-weight bearing for a specific period
  • Frequent visits to your surgeon to assess the progress
  • Wearing protective footwear as instructed

Benefits of Charcot Reconstruction

Charcot reconstruction has several benefits such as:

  • Reduced foot and ankle pain
  • Increased mobility and stability
  • Correction of deformity
  • Improved quality of life
  • The Arthroscopy Association of North America
  • The American Osteopathic Academy of Orthopedics (AOAO)
  • The American Academy of Orthopaedic Surgeons
  • American Orthopaedic Foot & Ankle Society┬«
    Orthopaedic Foot & Ankle Foundation
  • American Academy of Osteopathy
  • American Osteopathic Association