Charcot arthropathy - Treatment

Treatment of Charcot arthropathy is primarily nonoperative. It consists of two phases: an acute and a postacuta. Treatment includes immobilization and reduction of acute mechanical stress.Immobilization:Immobilisation is performed by allowing the patient to go to hearing and prevent warping. They are replaced every 1-2 weeks.patients with ulcers require debridement. The practice of monthly series radiography in acute phase to assess progress. Wearing hearing is required for 3-6 months and is cut according to X-rays, thermal studies. Other methods of restraint are metal rods and ortozele.Reduced mechanical stress:It will reduce the effective end grutatea sustained. Total removal is ideal weight. Patients usually do not accommodate this treatment.
Surgical therapy:It is performed in more than 25% of cases and is used as a preventative measure. Surgery is performed when a strain placed end to end when the risk of ulceration and can not be protected.The aim of reconstruction is to create a flat foot, stable may be protected by a special shoe to support and outpatient. Surgery is indicated for fractures or dislocations of malignancy, unstable or irreducible and where other methods have failed.Surgical procedures depend on the location of the disease and include projections exosteosectomii bone osteotomy, arthrodesis, fixation of screws and plates, autologous bone graft and amputation. Dischisa reduction and internal fixation are used for displaced ankle fracture. Ankle arthrodesis is necessary in patients with tibia destruction. If avascular necrosis of the talus and the practice fusion talectomia tibiocalcaneana.
Prognosis:Surgical therapy prolongs healing time. The extension also affects the healing wound. The more severe is the injury is healing so late and permanent deformation may occur. It generally requires 1-2 years for complete healing of Charcot joint.Charcot fractures that are not identified and treated properly marked may progress to joint deformity and ulceration of the skin on a bony prominence. Ulcers can cause severe infection and extremity amputation. Another complication of Charcot arthropathy is the collapse of flat foot and leg training. Other complications include structures ligament ossification, the formation of intra and extra-articular exostoze, arch collapse and development of osteomyelitis.