Leo J de Souza1. 1. Department of Orthopaedics-G2, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA. jill.lepper@co.hennepin.mn.us
Abstract
BACKGROUND: The standard management for Eichenholtz Stage-I Charcot arthropathy has been with non-weight-bearing total contact casts. The purpose of this study was to evaluate the results of the use of weight-bearing total contact casts for similar patients. METHODS: Twenty-seven patients with Charcot arthropathy of the foot and ankle were studied prospectively over a period of eighteen years, from 1988 to 2006. The average duration of follow-up was 5.5 years. Of the twenty-seven patients, twenty-six had diabetes mellitus. Total contact casts were used to treat thirty-four feet with Eichenholtz Stage-I or early Stage-II Charcot arthropathy. These patients were allowed to bear weight as tolerated. Casts were changed at weekly intervals and were worn until resolution of the acute stage of the disease. RESULTS: No deleterious effect from weight-bearing, specifically with regard to skin ulceration or rapid deterioration of the osseous architecture, was observed in thirty-three of the thirty-four feet. CONCLUSIONS: Immobilization in a weight-bearing total contact cast appears to be a safe method of treatment of acute Eichenholtz Stage-I Charcot arthropathy of the foot and ankle.
BACKGROUND: The standard management for Eichenholtz Stage-I Charcot arthropathy has been with non-weight-bearing total contact casts. The purpose of this study was to evaluate the results of the use of weight-bearing total contact casts for similar patients. METHODS: Twenty-seven patients with Charcot arthropathy of the foot and ankle were studied prospectively over a period of eighteen years, from 1988 to 2006. The average duration of follow-up was 5.5 years. Of the twenty-seven patients, twenty-six had diabetes mellitus. Total contact casts were used to treat thirty-four feet with Eichenholtz Stage-I or early Stage-II Charcot arthropathy. These patients were allowed to bear weight as tolerated. Casts were changed at weekly intervals and were worn until resolution of the acute stage of the disease. RESULTS: No deleterious effect from weight-bearing, specifically with regard to skin ulceration or rapid deterioration of the osseous architecture, was observed in thirty-three of the thirty-four feet. CONCLUSIONS: Immobilization in a weight-bearing total contact cast appears to be a safe method of treatment of acute Eichenholtz Stage-I Charcot arthropathy of the foot and ankle.
Authors: David R Sinacore; Mary K Hastings; Kathryn L Bohnert; Michael J Strube; David J Gutekunst; Jeffrey E Johnson Journal: Bone Date: 2017-09-20 Impact factor: 4.398
Authors: Mary K Hastings; Jeffrey E Johnson; Michael J Strube; Charles F Hildebolt; Kathryn L Bohnert; Fred W Prior; David R Sinacore Journal: J Bone Joint Surg Am Date: 2013-07-03 Impact factor: 5.284