TRIPLE ARTHRODESIS FOR DIABETIC PERITALAR NEUROARTHROPATHY

From 1963 to 1990, the senior authors (R.E.M. and K.G.H.) performed ei ght triple arthrodeses in seven patients with diabetes mellitus with s ensory loss in the lower extremities. By clinical and roentgenographic examination, all patients were diagnosed with peritalar neuroarthropa thy before surgery. All patients underwent a two-incision triple arthr odesis with internal fixation. Patient follow-up averaged 44 months an d included repeat physical examinations and radiographs. AII patients went on to clinical union and were satisfied with the procedure. One p atient had prolonged wound drainage that resolved with antibiotic ther apy; another had a residual rocker-bottom deformity and plantar ulcera tion that resolved after modification of custom shoe wear. We believe comprehensive management of diabetic peritalar neuroarthropathy can in clude surgical arthrodesis of the involved joints. The disease process and surgical indications are discussed.