Foot & ankle international · 2013
Navicular subluxation as a radiographic finding in Charcot neuroarthropathy.
СтатьяНазвание и аннотация: Перевод в очереди
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Estess Allyson, Marquand Nicole, Charlton Timothy P, Thordarson David B
Аннотация
BACKGROUND: Treatment of patients with Charcot midfoot destruction is a difficult and increasingly common clinical problem. The pathoanatomical features of Charcot neuropathy have been evaluated in only a few studies. This study evaluated whether medial navicular subluxation (adduction of the navicular on the talus) is a radiographic finding present in patients with Charcot neuroarthropathy.
METHODS: A retrospective review of 143 consecutive patients diagnosed with Charcot arthropathy of the foot from January 2004 to May 2011 was performed. Patients were identified based on a clinical diagnosis code 713.5 during an outpatient clinic visit with 2 surgeons at a single institution. After exclusion criteria were applied, a series of radiographs of 50 feet in 40 patients were compared with radiographs from an age-matched control group. Radiographic data including talonavicular coverage angle and talonavicular uncoverage percentage were collected.
RESULTS: The mean talonavicular coverage angle of the Charcot arthropathy group was 1.5 degrees and of the control group 12.1 degrees (P < .05). The talonavicular uncoverage value for the Charcot arthropathy group was 12.2% and for the control group 22.0% (P < .001).
CONCLUSIONS: Medial navicular subluxation was a radiographic finding that was more commonly present in patients with Charcot arthropathy than in a matched control group. It is theorized that this finding is attributable to an unopposed pull of the posterior tibial tendon on the destabilized navicular.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
METHODS: A retrospective review of 143 consecutive patients diagnosed with Charcot arthropathy of the foot from January 2004 to May 2011 was performed. Patients were identified based on a clinical diagnosis code 713.5 during an outpatient clinic visit with 2 surgeons at a single institution. After exclusion criteria were applied, a series of radiographs of 50 feet in 40 patients were compared with radiographs from an age-matched control group. Radiographic data including talonavicular coverage angle and talonavicular uncoverage percentage were collected.
RESULTS: The mean talonavicular coverage angle of the Charcot arthropathy group was 1.5 degrees and of the control group 12.1 degrees (P < .05). The talonavicular uncoverage value for the Charcot arthropathy group was 12.2% and for the control group 22.0% (P < .001).
CONCLUSIONS: Medial navicular subluxation was a radiographic finding that was more commonly present in patients with Charcot arthropathy than in a matched control group. It is theorized that this finding is attributable to an unopposed pull of the posterior tibial tendon on the destabilized navicular.
LEVEL OF EVIDENCE: Level IV, retrospective case series.