Department of Orthopaedics and Traumatology, İstanbul School of Medicine, İstanbul University, İstanbul, Turkey.
Acta Orthop. 2020 Jun;91(3):336-340. doi: 10.1080/17453674.2020.1746605. Epub 2020 Apr 1.
Background and purpose - Hindfoot arthrodesis using retrograde intramedullary nailing assumes a critical role in limb salvage for patients with diabetic Charcot neuro-arthropathy (CN). However, this procedure is compelling and fraught with complications in diabetic patients. We report the mid-term clinical and radiological outcomes of retrograde intramedullary nailing for severe foot and ankle deformity in patients with diabetic CN.Patients and methods - Hindfoot arthrodesis was performed using a retrograde intramedullary nail in 24 patients (15 females) with diabetic Charcot foot. The mean age of the patients was 62 years (33-82); the mean follow-up was 45 months (24-70). The primary outcomes were rates of fusion, limb salvage, and complications.Results - The overall fusion rate was 23/24, and none of the patients needed amputation. The rate of superficial wound infection was 4/24, and no deep infection or osteomyelitis was observed postoperatively.Interpretation - For selected cases of diabetic CN with severe foot and ankle deformity, hindfoot arthrodesis using a retrograde intramedullary nail seems to be a good technique in achieving fusion, limb salvage, and avoidance of complications.
背景与目的 - 逆行髓内钉固定后足在糖尿病性夏科氏神经关节病（CN）患者的保肢治疗中具有重要作用。然而，对于糖尿病患者来说，这种手术具有挑战性且并发症较多。我们报告了 24 例糖尿病性夏科氏足严重足踝畸形患者采用逆行髓内钉治疗的中期临床和影像学结果。
患者和方法 - 对 24 例（女性 15 例）糖尿病性夏科氏足患者采用逆行髓内钉进行后足融合术。患者的平均年龄为 62 岁（33-82 岁）；平均随访时间为 45 个月（24-70 个月）。主要结果是融合率、保肢率和并发症发生率。
结果 - 24 例患者中，23 例融合，无患者需要截肢。24 例中，有 4 例出现浅表伤口感染，术后无深部感染或骨髓炎。
结论 - 对于严重足踝畸形的糖尿病性 CN 选择病例，逆行髓内钉固定后足融合术似乎是一种良好的技术，可以实现融合、保肢和避免并发症。
