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Re: Charcot's Ankle
Dr Andrea Salvi 15 Январь 2007, 04:57
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Dear colleague,
because of the particular features of the Charcot disease, in order to obtain a good outcome following surgical operation, it is better to
wait the period of its remission.
Certainly, anytime this ankle will be operated during the active period, a bad result due to the bone remodellation (i.e. mobilizing of plates) will occur.
Therefore it is important to observe, by seriated x-rays of the ankle, the evolution of the disease in order to operate only when a "cold" period will be available. In my opinion, at this moment it is not appropriate to operate.
Best Regards,
Andrea E. Salvi - MD
Mellino Mellini Hospital Trust
Civil Hospital of Iseo (Brescia), Italy
Orthopaedics and Traumatology Department
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Re: Charcot's Ankle
Alexander Chelnokov 15 Январь 2007, 10:30
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JM> a TTC fusion after removal of metalwork and healing of ulcer?
JM> Patient wants to walk and a bit reluctant for an amputation which
Yes, arthrodesis looks most suitable. It would be optimal to start now with preliminary gradual correction by an external fixator. Either Ilizarov or Taylor/hexapod circular frame. It would help soft tissue to heal, and make the definitive surgery much smoother.
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Re: Charcot's Ankle
Shreekant Gupta 15 Январь 2007, 17:14
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hi Jayshil
i think amputation is better option. arthrodesis will take long time to heal and she may need orthotics afterward which will also create problem for her.
Looking to alignment and quality of bone chances of complications will be high and you may have to resort to amputation later on
thanks
shreekant gupta
Neath Port Talbot Hospital
South Wales
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Re: Charcot's Ankle
A Liberson 19 Январь 2007, 18:30
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I myself would go for a retrograde locking nail fusing pantalarly(optional talectomy) resecting enough bone to contain everything.
Circular frame is an adequate alternative. For fusion I would turn down both the metal and the fibula. Additional medial incision would help.
A Liberson
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