Surgeon, Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway.
Surgeon, Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Østfold Hospital, Grålum, Norway.
J Foot Ankle Surg. 2020 Mar-Apr;59(2):394-398. doi: 10.1053/j.jfas.2019.02.007.
Charcot neuroarthropathy is a rare condition that often results in deformity of the foot and ankle, with a high incidence of ulceration and a high risk of amputation. Traditionally, treatment of the acute stages of Charcot foot has been nonoperative until consolidation. Still, a large number of patients develop deformities, and early operative treatment of unstable Charcot feet has been suggested. To overcome some of the inherent challenges when operating on acute-stage Charcot feet, the superconstruct technique has been proposed. Early surgery for dislocated Charcot foot is sparingly described in the literature. To investigate the utility of the superconstruct technique for acute midfoot Charcot, we planned a prospective cohort study including patients with midfoot manifestation (Brodsky 1) in the active stages of the disease. Patients eligible for the study were treated with open surgery and midfoot arthrodesis using the superconstruct technique. In this report, we present the development of periprosthetic fractures related to early surgery using the superconstruct technique, possibly causing a more proximal Charcot manifestation in 2 patients with >24 months of follow-up. To our knowledge, such complications have been sparsely noted in the literature.
夏科氏关节病是一种罕见的疾病，常导致足部和踝关节畸形，溃疡发生率高，截肢风险高。传统上，夏科氏足的急性阶段的治疗是非手术的，直到愈合。尽管如此，仍有大量患者出现畸形，因此建议对不稳定的夏科氏足进行早期手术治疗。为了克服在急性夏科氏足手术中遇到的一些固有挑战，提出了超级构建技术。文献中很少有关于脱位性夏科氏足早期手术的描述。为了研究超级构建技术在急性中间足夏科氏病中的应用，我们计划进行一项前瞻性队列研究，包括处于疾病活动期的中间足表现（Brodsky 1）的患者。有资格参加研究的患者接受了开放性手术和使用超级构建技术的中间足关节融合术。在本报告中，我们介绍了使用超级构建技术进行早期手术时与假体周围骨折相关的问题，这可能导致 2 例随访时间超过 24 个月的患者出现更靠近近端的夏科氏表现。据我们所知，此类并发症在文献中很少被注意到。
