Antibiotic-coated nail for fusion of infected charcot ankles.

Abstract

Treating infected ankles in patients with neuropathy is difficult, and complications are frequently encountered. Eradication of infection and effective arthrodesis are required for a successful outcome. The purpose of this study was to evaluate the outcomes of patients with Charcot neuropathy whose infected ankles were treated with a retrograde, antibiotic-coated, locked intramedullary nail. We analyzed 5 patients with infected neuroarthropathy of the ankle joint. Three patients had failed treatment with the circular external fixator for infected neuroarthropathy of the ankle. The other 2 were treated primarily by this technique. All patients were treated with surgical nonunion repair, arthrodesis, and insertion of an antibiotic-coated, locked intramedullary nail. The average age was 59 years (range, 46 to 82 years). The average follow up period was 18 months (range, 12-24 months). The average time taken for radiological healing was 4.1 months (range, 4-4.5 months). In all patients, bony union was achieved and infection was eradicated. There were no cases of hardware failure. Antibiotic-coated nails were used to treat infected ankle nonunions and infected distal tibial fractures in Charcot patients with successful bony union, fusion, and eradication of infection. Level IV, therapeutic study.