1. 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

2. Case description Insulin-dependent, physically active nurse Neuropathy
Unstable ankle fracture
Fails in valgus

3. Case description

4. Reoperation—postoperative x-rays

5. Failure after second reconstruction
Loss of height, unstable, loss of great portions of talus
Cannot accept orthoses—ulcerations

6. 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!

7. 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