Date: January 30, 2024
Charcot neuroarthropathy (CN), a complication of diabetes-related neuropathy, is a serious condition that can cause significant foot and ankle deformities, chronic ulcers, and even limb loss. The condition often requires large limb salvage reconstructions of the foot and ankle to correct equinovarus deformities, as well as to create a stable, plantigrade foot.
In the case study, Surgical Reconstruction in a Single Patient with Bilateral Avascular Necrosis of the Talus, first author Kanika Kochhar, DPM, along with co-authors Cara Fontana, DPM and Brandon Gumbiner, DPM, highlight the outcomes of a female patient with severe foot and ankle deformity secondary to CN and avascular necrosis (AVN) of the talus to bilateral feet.
The patient underwent two different surgical approaches to correct the foot and ankle deformities. Her right lower extremity was treated surgically with a blade plate, while her left lower extremity was treated with an intramedullary rod. The patient’s presentation was also complicated by Charcot-Marie-Tooth, an inherited disorder of the peripheral nerves, caused by changes or mutations, in a person’s genetic material.
Dr. Kochhar and her colleagues reported that while both limbs have a brace-able functional foot today, a failure in the hardware used in the left limb contributed to the recurrence of her foot deformity and subsequent wound development.
Dr. Kochhar saw this patient when she was a podiatry resident at Katherine Shaw Bethea (KSB) Hospital in Dixon, Illinois. Dr. Kochhar is now a second-year fellow in the Michigan Medicine Podiatry Fellowship Training Program and will graduate in June 2024.
Dr. Kochhar works extensively in the inpatient setting, while also treating patients in the outpatient clinic and Comprehensive Wound Care Clinic. Her research focus is on Charcot neuroarthropathy and related chronic ulcerations, and those at risk for limb loss. She plans to continue pursuing research in these areas in her career.
Paper cited: Surgical Reconstruction in a Single Patient with Bilateral Avascular Necrosis of the Talus. Dr. Kochhar thanks her KSB colleagues, Dr. Cara Fontana and Dr. Brandon Gumbiner, for their work on this publication.
The Michigan Medicine Podiatry Fellowship Training Program provides clinical training in several different areas of related medical specialties, with an emphasis on research and patient populations at risk for limb loss. Learn more.
