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Fancy Footwork

January 2006

by Natalie Gutierrez

A normal ankle and foot.

A normal foot and ankle.

Charcot neuroarthropathy is a condition marked by the loss of sensation in the foot and the collapse of the bones in the ankle and foot. The condition results from complications of diabetes and peripheral neuropathy and usually leads to ulceration and eventually, infection in the feet and ankles.

Collapsed cartilage and bones apply pressure to the bottom of the foot, causing additional ulceration.

A foot with Charcot neuroarthropathy.
A foot and ankle placed in a multiplane circular external-fixation device

In most cases, the deformity is aligned in a staged- reconstruction procedure, in which Dr. Thomas Zgonis cleans the ulcer and repairs the collapsed bone and cartilage. In addition, plastic surgery techniques might be necessary to close the diabetic wound.

The foot and ankle are placed in a multiplane circular external-fixation device that resembles a small metal cage. The fixator repositions the foot and ankle to their normal alignment.

Usually, after eight to 10 weeks, the fixator is removed and the foot and ankle are placed in a cast. Patients normally can walk again, with the help of a cane or walker and special shoes, six to eight weeks after the cast is removed.

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