Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series

Aim: This case series reviewed challenging cases of Charcot neuropathy (CN) of the ankle joint and the efficacy of limb salvage procedures. Background: Charcot neuroarthropathy (CN) is a chronic debilitating pathology involving bone and joints, especially when affecting weight-bearing joints. Unfort...

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Main Authors: Raden Andri Primadhi, Ghuna Arioharjo Utoyo, Muhammad Naseh Sajadi Budi
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-07-01
Series:Journal of Foot and Ankle Surgery (Asia Pacific)
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Online Access:https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1288
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author Raden Andri Primadhi
Ghuna Arioharjo Utoyo
Muhammad Naseh Sajadi Budi
author_facet Raden Andri Primadhi
Ghuna Arioharjo Utoyo
Muhammad Naseh Sajadi Budi
author_sort Raden Andri Primadhi
collection DOAJ
description Aim: This case series reviewed challenging cases of Charcot neuropathy (CN) of the ankle joint and the efficacy of limb salvage procedures. Background: Charcot neuroarthropathy (CN) is a chronic debilitating pathology involving bone and joints, especially when affecting weight-bearing joints. Unfortunately, due to its relatively mild initial symptoms, many patients come to the hospital when CN is already in an advanced stage. When deciding between amputation and limb salvage, some aspects must be considered—general condition, local ankle condition, and availability of surgical equipment. Case description: We report three CN cases that presented late because of a lack of patient awareness or physician underdiagnosis. Despite ankle joint obliterations, all cases were successfully treated by limb salvage comprising debridement, reduction, and fixation using an intramedullary nail to achieve tibiocalcaneal arthrodesis. Patients’ weight-bearing ability was restored, and short-term quality of life was improved, despite varied fusion rates. Conclusion: Limb salvage by tibiocalcaneal arthrodesis using an intramedullary nail is a feasible option for CN, even in advanced stages with massive periarticular obliteration. Clinical significance: To avoid worsening conditions resulting from the underdiagnosis of CN, health promotion should be emphasized not only for the primary care clinician but also for the community as a whole. Although normal function is still difficult to achieve, treating advanced-stage CN by limb salvage will improve patients’ quality of life and daily activities.
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spelling doaj-art-bbbbf4b6ac834946b7acb8ea1ac39ece2025-08-20T02:27:57ZengJaypee Brothers Medical PublisherJournal of Foot and Ankle Surgery (Asia Pacific)2348-280X2394-77052023-07-0110313513910.5005/jp-journals-10040-12887Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case SeriesRaden Andri Primadhi0https://orcid.org/0000-0002-5825-5941Ghuna Arioharjo Utoyo1Muhammad Naseh Sajadi Budi2Raden Andri Primadhi, Department of Orthopaedics and Traumatology, Faculty of Medicine, Padjadjaran University/Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Orthopaedics and Traumatology, Faculty of Medicine, Padjadjaran University/Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Orthopaedics and Traumatology, Faculty of Medicine, Padjadjaran University/Hasan Sadikin Hospital, Bandung, IndonesiaAim: This case series reviewed challenging cases of Charcot neuropathy (CN) of the ankle joint and the efficacy of limb salvage procedures. Background: Charcot neuroarthropathy (CN) is a chronic debilitating pathology involving bone and joints, especially when affecting weight-bearing joints. Unfortunately, due to its relatively mild initial symptoms, many patients come to the hospital when CN is already in an advanced stage. When deciding between amputation and limb salvage, some aspects must be considered—general condition, local ankle condition, and availability of surgical equipment. Case description: We report three CN cases that presented late because of a lack of patient awareness or physician underdiagnosis. Despite ankle joint obliterations, all cases were successfully treated by limb salvage comprising debridement, reduction, and fixation using an intramedullary nail to achieve tibiocalcaneal arthrodesis. Patients’ weight-bearing ability was restored, and short-term quality of life was improved, despite varied fusion rates. Conclusion: Limb salvage by tibiocalcaneal arthrodesis using an intramedullary nail is a feasible option for CN, even in advanced stages with massive periarticular obliteration. Clinical significance: To avoid worsening conditions resulting from the underdiagnosis of CN, health promotion should be emphasized not only for the primary care clinician but also for the community as a whole. Although normal function is still difficult to achieve, treating advanced-stage CN by limb salvage will improve patients’ quality of life and daily activities.https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1288anklecharcot neuroarthropathylimb salvage
spellingShingle Raden Andri Primadhi
Ghuna Arioharjo Utoyo
Muhammad Naseh Sajadi Budi
Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series
Journal of Foot and Ankle Surgery (Asia Pacific)
ankle
charcot neuroarthropathy
limb salvage
title Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series
title_full Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series
title_fullStr Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series
title_full_unstemmed Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series
title_short Limb Salvage for Charcot Neuroarthropathy of the Ankle Joint: A Case Series
title_sort limb salvage for charcot neuroarthropathy of the ankle joint a case series
topic ankle
charcot neuroarthropathy
limb salvage
url https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1288
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