Salvaging The Limb - Outcome Of Hindfoot Fusion In Chopart’s Amputee With Diabetic Charcot Arthropathy

Abstract

Chopart’s amputations often have better outcome compared to higher level amputation with limb length preservation, larger weight bearing surface, and lower energy demand. Diabetic Charcot arthropathy and severe foot deformity is a treatment challenge. Reconstructive surgery with hindfoot arthrodesis is viable for plantigrade and stable foot, more fitting for orthotic shoe wear. We described a 62-years old male with underlying type 2 diabetes mellitus, presented with infected left diabetic foot ulcer and treated with Chopart’s amputation. Debridement of the Chopart’s stump was done, the wound healed and patient ambulating with a shoe filler. A year later, he noticed a progressive varus deformity of the left ankle following a trivial fall. He was in pain thus unable to bear weight. The hindfoot was in equino-varus deformity with tight Achilles tendon and uncorrectable, leading to left hindfoot fusion. Patient was able to progress to full weight bearing ambulation with no pain post-operatively.