Hindfoot Charcot Reconstruction

Deformity Correction

Hindfoot Charcot Reconstruction with TTC Fusion

An infected, unstable diabetic hindfoot Charcot with a near-lost talus, staged through debridement and an antibiotic spacer before a nail-assisted TTC and TN fusion.

Patient Age

58 Years

MECHANISM

Diabetic Charcot

PRESENTATION

Infected, Unstable Hindfoot

APPROACH

Staged Debridement, Nail-Assisted TTC and TN Fusion

01 Clinical Rationale

Infection had to be cleared before anything could be rebuilt, so an antibiotic cement spacer bought time in the first stage. Fusion was then extended across the hindfoot and up to the ankle to create stability where the talus was effectively gone.

02 Surgical Approach

Surgery was staged: stage one was debridement with an antibiotic cement spacer to clear infection. Stage two, after spacer removal, was a nail-assisted tibiotalocalcaneal (TTC) fusion plus a talonavicular fusion with a plate, extending fusion across the destabilised hindfoot.

02 Imaging & Progression

Pre-operative imaging, intra-operative views and post-operative results. Each slot maps to a CMS image field — drop in the matching consented file from the case folder.

#1

Hindfoot Charcot is a challenging entity requiring robust, extensive fusion.

#2

Fusion of most of the hindfoot joints is typically needed.

#3

Extension of the fusion to the ankle is quite a common requirement.

#4

Infection must be cleared with a staged spacer before definitive fusion.

04 Clinical Care Points

RIGHT SIDE

LEFT SIDE

| 35+ YEARS OF TRUST, CARE & EXCELLENCE

Hindfoot Charcot Reconstruction with TTC Fusion

An infected, unstable diabetic hindfoot Charcot with a near-lost talus, staged through debridement and an antibiotic spacer before a nail-assisted TTC and TN fusion.

A 58-year-old man with diabetes presented with an infected, unstable Charcot deformity of the hindfoot. Most of the talus had been destroyed, and an ulcer created an additional route for contamination and continued breakdown. Limb salvage required infection control first, followed by a reconstruction strong enough to bridge major bone loss.

During the first stage, infected and nonviable tissue was thoroughly debrided and an antibiotic-cement spacer was inserted. Once infection control was established, the spacer was removed and a nail-assisted tibiotalocalcaneal fusion was performed, supplemented by plate fixation across the talonavicular joint. The long, multi-joint construct bridged the diseased zone and provided stability despite the missing talus.