The Role of Internal Offloading and Rotational Flap Closure of Charcot Arthropathy-Related Midfoot Ulcers

The patient with Charcot foot is seldom studied for their body’s ability to heal an open diabetic foot ulcer. These patients are usually excluded from all prospective randomized trials. Over a 5-year period, patients with Charcot arthropathy (CA) have been shown to have a 63% chance of developing a CA foot ulcer (CAFU), and those with a foot ulcer have a 37% mortality within the same timeframe.¹ To the authors’ knowledge, a correlation between healing a CAFU and mortality reduction has not been indicated. It is well-known that healing such ulcers improves quality of life and reduces the chance of hospitalization. The primary modality to heal such an ulcer is maintaining or creating a plantar grade foot.1 In a retrospective study of 106 patients with CAFU, Schmidt and Holmes² reported that 44% of the patients’ ulcers had healed, 11% had received a minor amputation, and only 9% had undergone major amputation … read more