Information for Patients

Charcot arthropathy is a destructive disease process that creates significant deformity of the foot and ankle. It is most commonly found in patients who have long-standing diabetes (10+ years) and the comorbidity of peripheral neuropathy. The peripheral neuropathy associated with diabetes is just one of the multiple pathological organ system expressions associated with the disease process. Nerve dysfunction, as much of diabetes-specific organ dysfunction, appears to be a consequence of glycosylated hemoglobin acting at the arteriolar basement membrane of nerve fibers. This complex interaction gives rise to a progressive loss of function first appreciated in the smallest nerve fibers. With time, patients develop conduction defects in the sensory, motor, and autonomic components of peripheral nerves. There is virtually no role for nonsurgical treatment of even nondisplaced ankle fractures or Charcot ankle arthropathy in diabetic patient. A displaced ankle fracture in a diabetic patient with peripheral neuropathy is a potentially life-threatening event; rigid internal fixation is required. In this patient population, ankle fusion with retrograde locked intramedullary nail is generally performed through an anterior or transmalleolar approach.