Vacuum Scaling Drainage in the Treatment of Infected Elbow Charcot Neuroarthropathy: A Case Report and Literature Review.

BACKGROUND Charcot neuroarthropathy (CN) is a rare and easily misdiagnosed neuropathic arthropathy, often secondary to conditions such as syringomyelia and diabetes mellitus. Its clinical course is insidious, making early diagnosis challenging, and the presence of infection further complicates management. CASE REPORT This article reports a case of a 48-year-old male patient with elbow CN and secondary infection due to syringomyelia. The patient presented with swelling, erythema, and elevated skin temperature of the left elbow, but without significant pain. Imaging studies revealed elbow dislocation accompanied by extensive bony destruction. Laboratory test results showed a markedly elevated high-sensitivity C-reactive protein level (62.10 mg/L), and bacterial culture identified Staphylococcus aureus infection. After thorough debridement, the patient was treated with vacuum sealing drainage (VSD) combined with intravenous vancomycin for infection control. Following 2 sessions of VSD therapy, the infection was effectively controlled, with good granulation tissue formation, significant reduction in joint swelling, and negative bacterial culture results. At the 6-month follow-up, the elbow remained stable without signs of recurrent infection; the patient reported mild pain and limited range of motion, and definitive reconstructive surgery was deferred due to ongoing risk of infection and patient preference. CONCLUSIONS This case suggests that early and thorough debridement combined with VSD is an effective local treatment strategy for CN patients with infection. This approach aids in infection control and promotes wound healing, thereby creating favorable conditions for subsequent functional recovery. VSD, through continuous negative pressure drainage and irrigation, effectively removes necrotic tissue and exudate, improves local microcirculation, and demonstrates good application value in managing CN-related infections.