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A case of diabetic Charcot arthropathy of the foot and ankle

Nature Reviews Endocrinology volume 5, pages 577–581 (2009)Cite this article

Abstract

Background. A 61-year-old man with type 2 diabetes mellitus presented to a diabetic foot clinic 1 year after he injured his left foot in a slip injury. Examination showed collapse of the longitudinal arch with a rocker bottom deformity and a plantar ulcer under the plantar midfoot bony prominence.

Investigations. Radiographs of the foot.

Diagnosis. Diabetic Charcot arthropathy with rocker bottom deformity and plantar midfoot ulcer.

Management. The ulcer was initially treated by debridement and immobilization. Subsequently, the patient underwent surgery that consisted of plantar midfoot ostectomy to remove the bony prominence that had caused the ulcer, and midfoot osteotomy with realignment arthrodesis to reconstruct the longitudinal arch.

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Figure 1: The Charcot midfoot fracture–dislocation of the patient's left foot.
Figure 2
Figure 3: Surgical reconstruction of the rocker bottom deformity.
Figure 4: Improvement in the condition of the foot 5 months after surgical reconstruction.
Figure 5

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Acknowledgements

Charles P. Vega, University of California, Irvine, CA is the author of and is solely responsible for the content of the learning objectives, questions and answers of the MedscapeCME-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. Department of Medicine, Section of Infectious Diseases and Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada

    John M. Embil

  2. Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada

    Elly Trepman

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  1. John M. Embil
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Correspondence to John M. Embil.

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Embil, J., Trepman, E. A case of diabetic Charcot arthropathy of the foot and ankle. Nat Rev Endocrinol 5, 577–581 (2009). https://doi.org/10.1038/nrendo.2009.174

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