SURGICAL ARTHRODESIS OF THE NEUROPATHIC FOOT - A SALVAGE PROCEDURE

Reconstructive foot and ankle surgery is a salvage procedure in the de formed neuropathic foot, despite condemnation by some authors. Clinica l union and stability was achieved in 91% of the patients, and soft-ti ssue coverage without skin breakdown was achieved in 100% of the cases . Although one patient had moderate to severe pain in her ankle after operation and was able to do only bed-to-wheelchair transfers, she had good clinical stability, no skin ulceration, and was satisfied overal l with the procedure. In addition, a significant component of her pain was believed to be from diabetic neuropathy and not pain that was dir ectly attributable to her reconstructive surgery. All other patients w ere able to ambulate to some degree. More than half had unlimited use of the affected lower extremity. More than half of the patients had mi ld or no pain, and all patients had a functional limb. Surgical arthro desis of the deformed neuropathic foot as a salvage procedure can pres erve the limb as a stable functional unit, and create an acceptable al ignment of the ankle-foot complex that will promote viability of the o verlying soft-tissue structures.