MANAGEMENT OF NEUROPATHIC ARTHROPATHY WITH THE CHARCOT RESTRAINT ORTHOTIC WALKER

A recently designed Charcot Restraint Orthotic Walker (CROW) was used in the treatment of 18 patients with diabetic neuroarthropathy involvi ng the foot and ankle. Eight of these patients had no surgery before t he use of the CROW. In ten patients, the device was used for prolonged immobilization after surgery for complications of neuropathic joint d isease. The CROW is a rigid, custom, full-foot enclosure ankle-foot or thosis. It was used after an initial period of cast immobilization. Th e CROW effectively controls limb edema, returns the patient to ambulat ory activities, and prevents significant progression of deformity. All patients rated their satisfaction with the device as good or excellen t. The CROW is an attractive alternative to currently used methods to provide the prolonged immobilization and protection necessary for heal ing in neuropathic arthropathy.