Ankle fracture and complications in a diabetic patient Case for small group discussion AOTrauma Masters Course—Foot & Ankle Module 12: Charcot foot Per-Henrik Agren, Sweden
Case description Insulin-dependent, physically active nurse Neuropathy Unstable ankle fracture Fails in valgus
Case description
Reoperation—postoperative x-rays
Failure after second reconstruction Loss of height, unstable, loss of great portions of talus Cannot accept orthoses—ulcerations
Final result Ankle and subtalar fusion with bone block laterally Hindfoot arthrodesis nail (HAN) Nonweight bearing for 6 weeks (double time) Thereafter in CAM- walker Beware of the equinus!
Take home messages No standard ORIF for neuropathic ankle fractures Hindfoot fusion as a salvage procedure Good perioperative and long-term control of blood glucose levels reduces risk of complications