Ankle Arthrodesis using Cannulated Screws & Hybrid Type Rigid External Fixation in Diabetic Charcot Neuroarthropathy / 대한족부족관절학회지

PURPOSE: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. MATERIALS AND METHODS: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. RESULTS: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. CONCLUSION: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

Pseudomallet Finger Caused by an Osteochondroma from the Distal Part of the Middle Phalanx in a Child: A Case Report

Osteochondroma is the most common benign bone tumor around the metaphysis. Usually, it is originated from the peripheral area of metaphysis-physis junction due to mutation of physeal chondrocyte. This 1-year and 3-month-old boy presented with a mallet deformity. Radiographs showed an abnormal mass on the distal part of the middle phalanx. It was connected to the articular cartilage which was not associated with the physis. Operative and pathologic findings showed typical osteochondroma. After excision of the osteochondroma with sparing of the extensor tendon and immobilization for 6 weeks with a full extension splint, the pseudomallet deformity disappeared.