Midfoot Charcot Reconstruction Strategy

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Midfoot Charcot Reconstruction Strategy

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Күн бұрын

This is a Generic midfoot Charcot reduction strategy, whereby the normal architecture of the foot should be recreated in order to return to a plantigrade foot which evenly purchases the ground during stance. A Charcot breakdown in the midfoot could involve any combination of tarsal joints.
This newly rendered foot position renders the foot vulnerable to increased pressures and ulceration risk The strategy for reduction begins by assembling the foot from posterior to anterior, beginning with a Tendo Achilles lengthening. When the rearfoot is restored to optimal position, the soft tissue is addressed next
The soft tissue in this instance is often hypertrophic and fibrotic. This capsule must be dissected and joint exposure will benefit visualization.
With the release of the soft tissue, the forefoot segment can hinge into a more optimal angulation. The orientation of the osteotomy is designed to be perpendicular to the intended axis of the medial column This osteotomy is also placed at the junction, to divide the difference of the two overhanging segments. The fragments of overhang are removed when the osteotomy is complete
Next, the reduction can be shifted into position.
Then, with the alignment held, fixation can be placed. A ladder plating technique can be performed
©2014 DrGlass.org

Пікірлер: 26

@dryoutube 3 жыл бұрын

I'm a diabetes doctor and I commonly encounter patients with charcot foot! Optimal glycaemic control and a multi-disciplinary approach is key!

@pookysgrl 3 жыл бұрын

I'm a diabetic of 35 years (I was very young at diagnosis). I'd had an A1c below 7 my entire life but at age 25, charcot started in one foot then the other. Continual glucose control was maintained. I've also had renal failure. I'm not convinced it's all glucose. I'm low on Thiamin which after supplementing, things have improved. Please don't make flat statements that aren't as simple as you state. Drs should be professional enough to admit they don't have complete info.

@DrGlassDPM 10 жыл бұрын

Yes, I use Lightwave 3D to animate and render. I use adobe premier to edit

@lifeis2shortuk 10 ай бұрын

How long does take to recovery..?

@TheRhymeCreator 7 жыл бұрын

This I think will heaping me.

@adamsaleh1987 10 жыл бұрын

THis is better than some lecture I have had in school. Do you typically do this after the reconstruction phase? Are you a fan of frames?

@DrGlassDPM 10 жыл бұрын

I prefer the charcot to cool off and consolidate. Frames are very useful in certain scenarios

@noradennis4361 8 жыл бұрын

You illustrate where the Achilles tendon is cut. I presume it heals? I suffer from this condition and am hoping there is a way to fix my foot to a more normal condition. I hate being off balance when I try to do something as simple as walking across the room. While I do have a special shoe that helps ease pressure on the ball of bone, it still makes me unsteady on my feet and I constantly feel as if I'm going to fall over. Your animation has given me a little hope that perhaps my condition can be fixed. I have asked my foot doctor if I can have reconstructive surgery and he has constantly told me that I don't need it; but then HE doesn't have to walk around on a ball of bone all day. And though he has told me to stay off my foot, for a person who likes to go out and hike, this is an extremely hard thing for me to do. :) Only one time did I try to stay on my foot all day only to suffer for it for three days with pain from my foot to my rib cage on the side where the foot is deformed. And yes I was wearing my shoes but it was a foolish thing to do. I didn't want a wheelchair (which was available for rent at the park) and yet desperately wanted to get out and WALK. I can't tell you how tired I am of not being able to do the things I once was able to do before the injury to my foot. It seems to be a simple procedure and easily remedied. Perhaps it is time for me to get a second opinion. :) I don't have any ulceration on the bottom of my foot,, thank God, and according to my doctor it hasn't changed since the bones fell in 2008 after I fractured my foot. Maybe my condition has to be WORSE than it is in order to have the reconstruction? At any rate, perhaps it is time to seek a second opinion. Thanks for posting your video and giving me hope that perhaps my foot CAN be repaired to a more normal one. I just want to be able to walk normally again.

@sarahjohnson271 6 жыл бұрын

Nora Dennis I would suggest going to an orthopedic surgeon I just did this this past week and I found out that I have a mild charcot foot but they said that I didn't need surgery he said what's important is that the foot in the Ankle are 90° degrees I have some of the same issues as you do as far as the walking and feeling like you're going to fall over at times however I would rather keep my foot because what they don't show on KZfaq and other videos is that when they can't fix it that they end up having to amputate the foot and a lot of diabetics have to have amputation at times so just be very careful

@liscoll 4 жыл бұрын

It's best to see a podiatrist as they specialize in all things related to the foot and lower extremities. Their expertise goes beyond just diagnosis and repair. They will get you back up and going pain free and have you walking (gait) at optimal performance to reduce future injuries or incidents of pain.

@jonathanshih7128 9 жыл бұрын

Nice Work

@DrGlassDPM 9 жыл бұрын

Jonathan Shih Thanks buddy

@Hazztech 4 жыл бұрын

I wonder what my high arch looks like in an xray

@minigiant8998 3 жыл бұрын

im guessing it looks like a high arch.

@barbarapieters5870 2 жыл бұрын

I guess, I know, that an aperation on a Charcotfoot can be a great risk, amputation, because the skin of a Charcotfoot is very very vonerable and will be amputated afterall

@blaby4ever 8 жыл бұрын

Is any sort of incision of the achilles tendon made in the foot to remove any tension the patient may have after the surgery for better plantar flexion and balance?

@zealkurusuthegatorman5439 3 жыл бұрын

I have Charcot foot and I'm scared of infections! Is they're anyway of preventing it?

@yuw777 2 ай бұрын

calcium loss causes it as one cause. More milk??

@craigoverholt7168 Жыл бұрын

How can I find out more???

@ra339801 10 жыл бұрын

Did you animate this? If so, what software program?

@sirimani7114 4 жыл бұрын

Sir I have same problem please tell me how to get this flat foot operation

@srikanthvemareddy2432 3 жыл бұрын

Same proble how to solution

@pookysgrl 3 жыл бұрын

What is done to reattach the Achilles?

@minigiant8998 3 жыл бұрын

sometimes it's a lengthening of the achilles without completely detaching, or they resect the gastroc muscle to lengthen the back.

@pcavesnana Жыл бұрын

Don't Do It. The progressive atrophy of muscle tissue & tendons in our CMT DNA can not hold the surgical realignment together. It slides apart. For me, the result was being hobbled. Sure, the Before picture looks great! The After picture & X-Ray is horrific. All that hardware just moved with the collapse of both of my ankles. The tendon transfers have been rotating each foot upside down. Very painful. Lots of damage. Please just consider my story. Good luck!