Charcot Foot

Question 1

Name some causes for Charcot deformity.

Answer 1

diabetes 
syphilis
leprosy
syringomyelia
polio
spina bifida
chronic alcoholism

Question 2

What are the 2 theories for the Charcot process?

Answer 2

1. neurovascular- increased blood flow from autonomic neuropathy –> bone resorption
2. neurotramatic –> repeated trauma on an insensate foot results in joint destruction

Question 3

What is the Eichenholtz classification for Charcot deformity?

Answer 3

0) risk factor- no radiographic changes but the diabetic patient has a sprain or fx
1) development/ fragmentation- osteochondral fragmentation and debris formation
2) coalescence- absorption of debris and fusion of fragments into bone
3) reconstruction/consolidation- trabecular remodeling and osseous proliferation and ankylosis

Question 4

Name some differentials for Charcot joint disease.

Answer 4

acute septic arthritis
RA
psoriatic arthritis
OA
neoplasms

Question 5

what is the mainstay of treatment for acute neuropathic arthropathy?

Answer 5

cessation of WB to prevent further destruction

Question 6

Name 3 immobilizers used in the care for acute Charcot with deep ulceration.

Answer 6

bivalve cast
CAM walker
CROW boot

Question 7

what does CROW boot stand for?

Answer 7

charcot restraint orthotic walker

Question 8

what are the goals of a charcot reconstruction?

Answer 8

stable, plantigrade foot with the ankle at 90 deg, hindfoot at 5-10 deg of valgus rotation

Question 9

what is the anatomic classification for Charcot?

Answer 9

Brodsky

Question 10

What is the Brodsky classification?

Answer 10

Type 1- Lisfranc's joint 
Type 2- Chopart's/ STJ 
Type 3A- Ankle
Type 3B- calcaneus
Type 4- multiple regions
Type 5- forefoot