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Midfoot Charcot Reconstruction Strategy

This is a Generic midfoot Charcot reduction strategy, whereby the normal architecture of the foot should be recreated in order to return to a plantigrade foot which evenly purchases the ground during stance. A Charcot breakdown in the midfoot could involve any combination of tarsal joints. This newly rendered foot position renders the foot vulnerable to increased pressures and ulceration risk The strategy for reduction begins by assembling the foot from posterior to anterior, beginning with a Tendo Achilles lengthening. When the rearfoot is restored to optimal position, the soft tissue is addressed next The soft tissue in this instance is often hypertrophic and fibrotic. This capsule must be dissected and joint exposure will benefit visualization. With the release of the soft tissue, the forefoot segment can hinge into a more optimal angulation. The orientation of the osteotomy is designed to be perpendicular to the intended axis of the medial column This osteotomy is also placed at the junction, to divide the difference of the two overhanging segments. The fragments of overhang are removed when the osteotomy is complete Next, the reduction can be shifted into position. Then, with the alignment held, fixation can be placed. A ladder plating technique can be performed ©2014 DrGlass.org