Information for Patients

Charcot foot arthropathy is a progressive disease that creates significant deformity of the foot and ankle in patients with diabetic neuropathy. Some inciting event, often trauma, initiates the destructive process. Diagnosis is usually made on the basis of clinical manifestations consisting of a painful, warm, swollen, and insensate foot, and is supported by radiographs. Management of Charcot foot arthropathy includes both nonsurgical and surgical treatment options. Nonsurgical treatment consists of immobilization of the foot in a weight-bearing total contact cast during the acute active phase of the disease until the foot is sufficiently stable to be managed in therapeutic footwear. Surgery is advised when the foot is clinically nonplantigrade and unbraceable, and includes the removal of all infected bone, correction of the deformity with arthrodesis, and lengthening of the gastrocnemius-soleus complex. This article describes the use of ring external fixation to maintain the correction.