Original ResearchBeaming the Columns for Charcot Diabetic Foot Reconstruction: A Retrospective Analysis
Section snippets
Patient Population
We reviewed 71 Charcot foot surgical reconstructions, performed in 70 patients treated in the private practice of the senior author (W.P.G.) from January 1994 to January 2008. All of the patients had peripheral neuropathy with loss of protective sensation, as determined by the absence of 10-gram monofilament skin sensation on 3 separate areas of the involved foot, and included Type 1 and Type 2 diabetic patients, as well as one nondiabetic patient with idiopathic peripheral neuropathy. Charcot
Results
The study included 70 patients (43 males and 27 females) with a mean age of 56.10 ± 11.29 (range 29–78) years, and an average body mass index (BMI) of 33.10 ± 6.83 (range 21.3–51.2). Seventy-one Charcot foot reconstructions (35 right and 36 left sides) were performed along with 1 bilateral case. The mean duration of time to procurement of the postoperative radiographs used to measure the radiographic angles used in the analyses was the mean follow-up duration of 31.00 ± 22.73 (range 3–92)
Discussion
In this study, the effect of beaming on the medial and lateral columns showed statistically significant improvements for a large subgroup of patients who underwent the beaming procedures. Beaming of the medial column entails placement of an intramedullary fixation screw through the medullary canal of the first metatarsal, then through the medial cuneiform and the navicular, and onward into the body of the talus. The beam acts to share the load with the bones, ligaments, and joints of the foot,
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