FRACTURES AND DISLOCATIONS OF THE FOOT AND ANKLE IN DIABETICS ASSOCIATED WITH CHARCOT JOINT CHANGES

This study was undertaken to evaluate the occurrence of Charcot joint changes in diabetic patients after fractures and/or dislocations of th e foot and ankle. There were 20 fracture/dislocations of the foot and ankle in 18 patients, with an average follow-up of 27 months (range 14 -70 months). There were eight fractures of the midfoot, six fractures of the ankle, four fractures of the hindfoot, and two fractures of the forefoot. Eight fractures were followed by the development of Charcot changes: five in the midfoot and one each in the forefoot, hindfoot, and ankle. Of nine fractures recognized early and initially treated by early immobilization or ORIF, seven healed uneventfully. Two fracture s, both open injuries, developed soft tissue infection and osteomyelit is, respectively. Of the 11 fractures in which there was a delay in di agnosis and treatment, eight developed Charcot changes. The early reco gnition and appropriate treatment of fractures in diabetic patients ap pears to be important in the prevention of Charcot joint changes.