Beaming the columns for Charcot diabetic foot reconstruction: a retrospective analysis

J Foot Ankle Surg. Mar-Apr 2011;50(2):182-9. doi: 10.1053/j.jfas.2010.12.002. Epub 2011 Jan 22.

Abstract

This study explored the concept of "beaming" the medial and lateral longitudinal columns as a variation of the current technique for hindfoot and Lisfranc Charcot reconstruction. We reviewed radiographic changes and outcomes for patients who underwent Charcot foot reconstruction at our facility over the 14-year period from January 1994 to January 2008. Beaming was performed on 71 Charcot foot deformities in 70 patients, 22 (31%) of which displayed an isolated hindfoot deformity, 20 (28%) an isolated Lisfranc deformity, and 29 (41%) with a combination of hindfoot and Lisfranc deformities. The average radiographic follow up was 31.00 ± 22.97 months. Group 1 consisted of reconstructions that involved only medial and lateral column beams and showed significant improvements in radiographic alignment between the preoperative and postoperative measurements, including Meary's angle (P < .001), calcaneal inclination angle (P = .004), tarsometatarsal angle (P = .002), talonavicular angle (P = .035), and the calcaneocuboid angle (P = .006). Group 2, which consisted of reconstructions that involved medial and lateral column beams and either a subtalar arthroereisis (n = 18) or a subtalar joint fusion (n = 10), also showed significant improvements, including Meary's angle (P < .001), tarsometatarsal angle (P < .001), talonavicular angle (P = .002), and the calcaneocuboid angle (P < .001), although calcaneal inclination did not statistically significantly change (P = .054). In both groups, the surgical intervention maintained the correction and was useful for Charcot reconstruction. Complications included pin tract infections, broken pin, osteomyelitis, transfer lesions, and ulcerations.

MeSH terms

  • Adult
  • Aged
  • Arthrodesis
  • Arthropathy, Neurogenic / diagnostic imaging
  • Arthropathy, Neurogenic / etiology
  • Arthropathy, Neurogenic / surgery*
  • Bone Screws*
  • Diabetic Foot / complications
  • Diabetic Foot / surgery*
  • Female
  • Foot Bones / surgery
  • Foot Deformities, Acquired / diagnostic imaging
  • Foot Deformities, Acquired / etiology
  • Foot Deformities, Acquired / surgery
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures*
  • Radiography
  • Retrospective Studies
  • Subtalar Joint / surgery