Description of patient (type of occupation, indication of age, intensity of sport):
50 Years old woman diabetic with since 10 years, pain and swelling of ankle.
History and previous treatment:
Pain and swelling of ankle , instability while walking.
Destruction of talus.
Additional investigation (CT/MRI):
Fluroscopic guided biopsy done, Histopathology features suggestive of Charcot joint.
52 years old diabetic woman with pain, swelling and instability of the ankle. Now the patient is treated conservatively with an air walker boot.
Question(s) to this case:
Should the management be surgical or conservative?
Yes this is Charchot joint with destruction in a diabetic patient. Best is to remain conservative and treat with an orthopaedic shoe. If not possible, then pantalar fusion using hindfoot nail. Time to healing is expected twice the normal time: this means 12 weeks non-weightbearing followed by 12 weeks weightbearing cast.