Comprehensive Management of Presumed Underlying Charcot Arthropathy with a Subsequent Traumatic Ankle Fracture in a Patient with Diabetes Mellitus, End-Stage Renal Disease: A Case Report
10.14193/jkfas.2025.29.1.34
- Author:
Gil-Won CHOI
1
;
Jung-Won LIM
;
Seung-Hwan PARK
Author Information
1. Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
- Publication Type:Case Report
- From:Journal of Korean Foot and Ankle Society
2025;29(1):34-40
- CountryRepublic of Korea
- Language:English
-
Abstract:
Charcot neuroarthropathy (CN), also known as Charcot arthropathy, is a complex, progressive disorder primarily affecting the foot and ankle. This case report describes a multifaceted management strategy for a 54-year-old male with diabetes mellitus, end-stage renal disease, and presumed underlying Charcot arthropathy who experienced a traumatic ankle fracture. The initial surgical plans were delayed because of systemic infection indicators, including elevated C-reactive protein levels and high fever. The patient underwent multiple surgical interventions and faced challenges, including metal failure, implant-associated infection, and tibiotalar joint dislocation. A multidisciplinary approach involving orthopedic surgeons, nephrologists, and endocrinologists was crucial for managing the case effectively.In particular, the patient declined a below-knee amputation and opted for comprehensive surgical intervention, resulting in improved functionality at the latest follow-up. This case highlights the complexities of managing CN in patients with multiple comorbidities and emphasizes the need for a nuanced, patient-centered approach.
