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"Diabetic nerve damage can cause a serious cascade of problems - including a loss of sensation in weight-bearing joints such as the ankles and feet - with a progressive weakening of the bones," explains Jack Bondi, DPM, Virtua podiatrist. "Because patients can't feel pain, bone fractures occur without individuals realizing it." These silent untreated fractures heal improperly and lead to deformity. The progressive deterioration associated with Charcot's neuroarthropathy, in a worst case scenario, can also result in tissue ulceration, sepsis and amputation.
Dr. Bondi says: "For the most severe Charcot's cases, there is a newer limb correction modality - an external spatial frame that corrects the deformity in three dimensions." This enables a precise installation not possible with conventional two-dimensional fixation devices.
Although it may also require some internal stabilization, performed through minimally invasive surgery, the advantage of the frame is its external nature - patients can self-adjust the frame, which can improve the rate of overall correction.
"Patient motivation and compliance are integral to the success of this technique," says Dr. Bondi, "but for those who can stay the course, up to three months or more, we can usually get them walking again - remarkable for this patient population."
This Virtua Physician article was last updated: August 25, 2008