Complications of foot and ankle surgery in patients with diabetes

Treatment of the foot and ankle in patients with diabetes often is fraught with complications, frequently multifactorial in nature. Because of the mul tidisciplinary approach to the patient with diabetes, it is imperative that the patient and all healthcare professionals who are treating the patient recognize the foot at risk, and the clinical hallmarks of Charcot neuroarth ropathy. Failure to do so often leads to disastrous results, such as ulcera tion, destruction of normal foot architecture, and progressive deformity to o severe to accommodate a brace, thereby necessitating surgical interventio n. The surgical treatment of the foot in a patient with diabetes requires k nowledge of the pathophysiology of the neuroarthropathic (Charcot) foot, so that the appropriate timing, extent of surgical intervention, and postoper ative treatment in this unique population assures a higher success rate. On e also must recognize associated factors that may be present in these patie nts, such as peripheral vascular compromise and poor nutritional status.