Safety and Efficacy of Plantar Exostectomies for the Management of Diabetic Charcot Midfoot Deformity: A Systematic Review.

Management of residual deformity in patients with Charcot Neuro-osteoarthropathy represents a therapeutic challenge. The midfoot is the most frequently affected area, leading to the typical rocker-bottom deformity. Surgical exostectomy in these areas of bony prominences offers a non-reconstructive method to remove pressure and allow ulcers to heal or prevent their development when conservative measures fail. This review includes a total of 11 studies, aimed to assess the outcome of exostectomies in the prevention and recurrence of ulcers under the bony prominence in patients with Charcot midfoot and its main complications. Exostectomy was successful in 60% of cases after the first surgery and in 90.7% of cases in total. The procedure, when done below the lateral column, seems to have a higher number of diverse complications. This fact must be taken into account when performing this procedure.