Neuropathic Fractures

Neuropathic Fractures

Charcot Neuroarthropathy

Charcot arthropathy results in progressive destruction of bone and soft tissues at weightbearing joints; in its most severe form, it may cause significant disruption of the bony architecture.

Charcot arthropathy can occur at any joint; however, it occurs most commonly in the lower extremity, at the foot and ankle.Diabetes is now considered to be the most common etiology of Charcot arthropathy.

Fine Wire External fixator with Minimally Invasive osteotomy

The goal of Charcot surgery is to create a stable, non ulcerated , plantigrade foot.

Neuropathic Fracture Post Operative Instructions


  • You will be in a external fixator/ cast for 12-16 weeks
  • At 16 weeks you will be warned to an aircast and then a CROW walker
  • A CROW walker will be warn to 6 months to 1 year


  • The surgical incision has been closed with sutures
  • Do not get the external fixator/ cast or wound wet for the first two weeks
  • Stitches will be removed at your 4-6 week appointment
  • After the stitches are removed, you may begin to shower after 2-3 days
  • Do not immerse the foot in water until instructed with external fixator
  • Do not apply any lotions or creams on the wound
  • With an external fixator you will receive CCAC dressing and pin site care

Weight Bearing:

  • You will be weight bearing immediately on the external fixator
  • If you are in a cast then you will be strict NON WB x 12-16 weeks
  • You will use a mobility device to offload your foot (crutches, walker, stirrup cast)


  • You will be given a prescription for pain medication and Aspirin (blood thinner)
  • Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol
  • Aspirin should be taken for 14 days (unless you have an allergy to aspirin)


  • For right foot surgery you are not permitted to drive until you have completely weaned off the boot
  • For left foot surgery, please contact your insurance company to see if you are permitted to drive
  • Driving is not permitted while on narcotics


  • Likely you will be off work 12-16 weeks
  • You may return to work in a seated/sedentary capacity when you feel able
  • Weight bearing precautions must be adhered too

Follow Up:

  • You will have your first appointment 2 weeks after surgery in the Fracture Clinic
  • Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
  • You will have x-rays taken at these appointments


  • It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
  • Please come to the emergency department if you are suffering from severe pain
  • You will get back to most of your activities by 6-12 months
  • Swelling often remains for 6-12 months
  • Residual stiffness is a normal consequence of ankle fracture