I am Dr. Premkumar, diabetic foot surgeon.This video is all about the management of acute Charcot arthropathy. You all know Charcot arthropathy is an in stage complication of diabetic neuropathy where the joints and the bones of the foot will get affected. Joints, ligaments, and tarsal bone significantly will get affected in diabetic neuropathy. So one such patient from West Bengal. You see the midfoot level, and you can see all the torsal bone.
There is a little bit of swelling here. It is all because of the bone prominence. The ligament will get loosened. So the architecture of the midfoot bones and the ligaments will get distorted. So patients usually, if they have a chart arthropathy, will have a black foot.
At the initial presentation, they will be swelling, walking and unable to walk. So all these three symptoms will be there in Charcot arthropathy. It is mainly a clinical diagnosis. Plus, you can take an MRI and an added extract. So if this is proven, the management of acute Charcot is similar to a fracture.
So how you emulate a fractured joint or a bone, the management applies for the acute Charcot also. So this patient, I have once applied a two blood cast, which is the second visit. Still, I can feel the temperature difference from the right foot to that of the left foot, and the spelling is there. So again, I’m going to put a tubular car, and if you want to see his MRI, you can see.
So you can see. These are the bones you could see balanced bone and a navicular bond and a CUNY pom bond. This is a major CUNY pom. All these textures. Suppose you see in these MRIs.
So there is entirely, totally discarded thymus bone, navicular bone and AC uniform bone. And this is coming down, and you can see these pictures of the acute charcoal property. So if this is not offloaded or mobilized by a tubular card, it will begin collapsing. This art will get collapsed, and ultimately the patient will have tropical. So sometimes they may lose the foot also.
So that is what I emphasize in this video, and I’m going to show how I am putting everything.
So I will demonstrate to you how to put a two-floor card for a Charcot arthropathy. As I told you in this earlier video, this patient has mitral Charcot arthropathy. So I’m applying paraffin oil. So paraffin oil prevents each sensation, and it is a moisturizer too. And then I’m going to apply a big pad to be well padded.
The second thing is applying for a soft role. Just putting a soft roll bandage is optional. Again, place the neutral ankle position 90 degrees when you keep it in position to get solidified; wait for a few minutes and then tap this.
Now it is in the process of settling. So after a few minutes, this will get solidified, and this is the proper way to put a two-block so that this ankle joint will be fixed entirely. I’m going to advise this patient to be incomplete address so every month I will change this one open this one assess the temperature difference retake CRP CPC account also so I usually put this kind of tubular cost for six months so that the fracture a retardant bone will get you certified.
Thanks for watching. Bye.