title: Serial casting for reconstruction of a deformed Charcot foot: a case report.
abstract: BACKGROUND
  Charcot neuroarthropathy may occur in patients with peripheral neuropathy who do not notice pain while their bones and joints collapse or breakdown under the constant pressure of body weight. This can lead to ulcerations from severe deformity and potentially limb-threatening and life-threatening infections. Current treatments vary from immobilization to extensive reconstructive surgical interventions.
  
  
  METHODS
  Serial casting, used to correct many pediatric deformities while bones are often more pliable, was used with a 63-year-old male patient who presented with an active phase of Charcot foot with ulceration. The patient previously underwent foot reconstruction and had all hardware removed prior to serial casting. Due to the potential pliability of the bones, serial casting was attempted to reform the shape and position of the foot in a reverse Ponseti-type serial casting to create a more stable structure with less deformity that could lead to epithelial breakdown.
  
  
  RESULTS
  The patient regained full ambulation with a plantargrade foot and no wounds, and was followed without complications for 36 months.
  
  
  CONCLUSIONS
  Serial weekly casting was an effective modality for treatment of this patient's Charcot foot deformity.
authors.affiliation: Shaarei Zedek Medical Center, Jerusalem, Israel; email:diabfootman@gmail.com.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Rosenblum
authors.affiliation: Shaarei Zedek Medical Center, Jerusalem, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Weiss
authors.affiliation: Yale New Haven Hospital, New Haven, CT.
authors.forename: Michael
authors.initials: M
authors.lastname: Gazes
authors.affiliation: Shaarei Zedek Medical Center, Jerusalem, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Amit-Kohn
mesh_terms: D001177:Arthropathy, Neurogenic / Q000150:complications / Q000473:pathology / Q000628:therapy*; D002370:Casts, Surgical; D003929:Diabetic Neuropathies / Q000150:complications / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D005500:Follow-Up Studies; D005528:Foot / Q000473:pathology*; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007103:Immobilization / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome; D016138:Walking