Study: Sagittal plane deformity may be linked to foot ulceration in Charcot patients

Issue: October 2014

CHICAGO — Deformities of the sagittal plane of the foot are more likely to be associated with foot ulceration in patients with diabetes who have Charcot neuropathy, according to data presented at the International Federation of Foot & Ankle Societies Triennial Meeting.

Dane K. Wukich

“I think the key thing is you have to have heightened awareness if you are treating Charcot patients when you see these patients developing progressive deformity in the sagittal plane.” Dane K. Wukich, MD, said here.

Wukich and colleagues evaluated 114 patients (60 without foot ulcers, 46 with ulcers) who were diagnosed with diabetic Charcot neuroarthropathy (CN). A control group of 35 patients with diabetic neuropathy who did not have CN was also included in the study. Digital radiographic measurements were made of the lateral and dorso-planar talar-first metatarsal angles, hindfoot forefoot angle, lateral tibiotalar angle, cuboid height, medial column height and calcaneal pitch.

While patients with both CN and foot ulcers were more likely to have type 1 diabetes, no difference in requirement for insulin use was observed. Chances of foot infection were significantly higher in patients with foot ulcers (37%) compared to patients without foot ulcers, as no patients without foot ulcers were found to develop foot infection. Wukich said that 24% of the patients who had ulcers had lateral talo-first metatarsal angles less than -27°. —by Christian Ingram

Reference:

Wukich DK. Radiographic analysis of charcot neuroarthropathy: A comparison of patients with and without foot ulcers. Presented at: International Federation of Foot & Ankle Societies Triennial Meeting; Sept. 19-21, 2014; Chicago.

Disclosure: Wukich has no relevant financial disclosures.