title: Soft Tissue Reconstruction Pyramid for the Diabetic Charcot Foot.
abstract: Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population. This article outlines in detail the stepwise approach and options available for durable soft tissue coverage in the DCN patient.
authors.affiliation: Orthopaedic Associates of Southern Delaware, 1539 Savannah Road, Suite 203, Lewes, DE 19958, USA. Electronic address: ccapobianco@delawarebonedocs.com.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Capobianco
authors.affiliation: Division of Podiatric Medicine and Surgery, Department of Orthopaedics, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, MSC 7776, San Antonio, TX 78229, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zgonis
mesh_terms: D001177:Arthropathy, Neurogenic / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003238:Connective Tissue / Q000601:surgery*; D017719:Diabetic Foot / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps
keywords: Charcot neuroarthropathy; Diabetic Charcot foot; Diabetic foot ulcer; Diabetic neuropathy; Plastic surgery; Reconstruction; Soft tissue pyramid