الفهرس | Only 14 pages are availabe for public view |
Abstract C harcot neuroarthropathy is a destructive, non-infective process affecting bones and joints that occurs in association with a peripheral neuropathy and it has many etiologies but diabetes is the first cause of charcot neuroarthropathy. Surgical reconstruction indicated in case of unstable, deformed, non plantigrade with recurrent ulcerations of the foot but in the quiescent stage while amputation indicated in cases of failed previous surgeries, recurrent resistant infection and ulcerations, severe bone destruction, longstanding foot dislocations and deformities. Goals of surgery are alignment and stabilization of foot, Restoration of stability, clearance of infection, relief of pressure points, prevent ulcerations to avoid amputation. Retrograde intramedullary nail and ilizarov external fixator both are effective methods for ankle fusion in charcot neuroarthopathy. According to this review the union rate, union time, amputation, hardware complications did not differ significantly between retrograde intramedullary nail and ilizarov in ankle fusion in charcot neuroarthropathy but the reoperation rate is higher with retrograde intramedullary nail. Regarding the infection rate there is no significant difference between the ilizarov and intramedullary nail but when considering the pin tract infection in ilizarov, the infection rate will become higher in ilizarov compared to the retrograde intramedullary nail. In conclusion, this review provides evidence that both retrograde intramedullary nail and ilizarov external fixator are safe, effective and has comparable efficacy in limb salvage when used in ankle reconstruction in patients with charcot neurparthropathy, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed. |