I am Dr. Premkumar, diabetic foot surgeon.This video is all about 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 and ligaments, and tarsal wounds especially will get affected in diabetic neuropathy. So one suspicion is from West Bengal. You see the midfoot level; you can able to see all the tarsal bone.
There is a little bit of swelling here. It is all because of the bony prominence; the ligaments will get loosen, so the architecture of the midfoot bones and the ligaments will get distracted. So patients usually, if they have a midfoot charcoal property, will have a flat foot. At the initial presentation, they will have swelling warm and unable to walk. So all these three symptoms will be there in acute Charcot arthropathy.
It is mainly a clinical diagnosis. Plus, you can take an MRI and an added xray. So if this is proven, the management of Acute Charcot arthropathy is similar to a fracture. So how do you emulate a fractured joint or a bone? The management applies for the acute Charcot also.
So this patient I have once applied a tubular cast, and this is the second visit. Still, I could able to feel the temperature difference from the right foot to that of the left foot, and the swelling was there. So again, I’m going to put a tubular cast, and if you want to see his MRI, you can see these are the bones you could able to see balanced bone and Neville’s bone and the CUNY pom bone. This is a major CUNY from all these sensors. If you see in this MRI, there is completely, totally discarded thymus bone, navicular bone, and a cuniform bone, and this is coming down you could be able to see these are the pictures of the acute shark art property.
So if this is not offloaded or immobilized by a tubular cast, then it will begin collapsing. This art will get collapsed, and ultimately patients will have tropic ulcers that sometimes they may lose the foot also. So that is what I emphasize in this video.
So I’m going to advise this patient to be an incomplete well dress. So every month I will change this one. Open this one assess the temperature difference. Take CRP again CPC count also. So I usually put BB this kind of tubular cost for six months so that the fractured bone will get cured solidified.
Thanks for watching. Bye.