title: Midtarsal Reconstructive Arthrodesis Using a Multi-Axial Correction Fixator in Charcot Midfoot Arthropathy.
abstract: Reconstructive surgeries for Charcot foot are challenging due to complicated conditions and comorbidities including poor bone quality, sensory abnormalities, poor vascularity, and immunity impairment. Although various ﬁxation devices, including screws, plates, and external ﬁxators, have been used in the surgical reconstruction of the Charcot midfoot, all of these devices are associated with some disadvantages. This study aims to evaluate the outcome of the Multi-Axial Correction (MAC) monolateral external ﬁxation system for the reconstructive surgery of midfoot Charcot neuroarthropathy. A total of 11 feet with midfoot Charcot arthropathy were treated surgically using the MAC fixation system solely or accompanied with minimal internal fixation. The mean postoperative follow-up was 29 (range = 12-44) months. The mean postoperative timing of the MAC system removal was 8.7 (range = 5-14) weeks. No pin tract infections were observed. All patients went on to successful union and correction of a rocker bottom deformity. No cases resulted in limb amputation. All patients were able to ambulate with custom diabetic shoes and insoles in 9 patients (10 feet) and commercially available shoes in 1 patient (1 foot). This study suggests that the MAC system can be an acceptable, easy option for the surgical treatment of midfoot Charcot arthropathy.
  
  
  METHODS
  Therapeutic, Level IV: Case series.
authors.affiliation: North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Duke Fuqua School of Business, Durham, North Carolina (SGP).
authors.forename: Takumi
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: North Carolina Orthopaedic Clinic, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (TM, SGP)Duke Fuqua School of Business, Durham, North Carolina (SGP) selene.parekh@gmail.com.
authors.forename: Selene G
authors.initials: SG
authors.lastname: Parekh
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000295:instrumentation*; D001177:Arthropathy, Neurogenic / Q000601:surgery*; D048909:Diabetes Complications; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Charcot arthropathy; MAC system; diabetes mellitus; external fixator; midfoot fusion