Midfoot and Hindfoot Charcot Deformity Correction is Well Maintained with Beam Fixation

Abstract

Category: Midfoot/Forefoot; Diabetes Introduction/Purpose: Charcot arthropathy is a neurotraumatic foot disorder seen in patients with peripheral neuropathy. Surgical reconstruction via medial column arthrodesis with beams can restore plantigrade foot anatomy with decreased soft tissue dissection and improved bony compression. Methods: We identified 12 patients with midfoot (n=7) or hindfoot (n=5) Charcot who underwent medial column beaming arthrodesis between 2015 and 2021 b y one of two fellowship-trained foot and ankle surgeons at an academic medical center. Data collected from patient charts included demographics, medical history, complications, and reoperation rate. Meary’s angle was measured on lateral weightbearing radiographs preoperatively and up to two years postoperatively. Mean follow-up time was 2.50 (range, 1.04-6.98) years. Statistical analysis included correlation, two-tailed Student t-test, and Chi-squared test. Results: Meary’s angle was recorded preoperatively for 12 patients (19.3° ± 6.7°) and postoperatively at three months for 12 patients (4.0° ± 6.7°), at six months for 12 patients (7.1° ± 9.7°), at one year for 11 patients (6.1° ± 9.4°), and at two years for five patients (10.2° ± 6.4°). However, two (16.7%) patients showed a loss of deformity correction, which was demonstrated by a Meary’s angle that was greater at final follow-up than preoperatively. Overall complication, infection, reoperation rates were 50.0%, 41.7%, and 58.3%, respectively. Finally, dependent on preoperative ulceration, those with and without an ulcer did not differ in Meary’s angle at any time point, overall complication, infection, nor reoperation rate. Conclusion: Although the results showed a relatively high complication rate, the use of beaming arthrodesis was generally able to maintain a plantigrade foot and overall alignment, while decreasing the recurrence of plantar ulceration.