Triple Arthrodesis as Surgical Management of Charcot Joint with AVN Talus Caused by Neglected Old Fracture Talus with History of Diabetic Type II: A Case Report

A chronic, non-infectious degenerative disease of the foot and ankle joints, Charcot neuroarthropathy (CN) is frequently linked to peripheral neuropathy and diabetes mellitus. Joint dislocation, fractures, and deformities are its hallmarks, and they can result in serious side effects such ulceration, osteomyelitis, and limb amputation. We report the case of a 53-year-old woman who was diagnosed with a neglected talus fracture and had a 23-year history of limping due to type 2 diabetes mellitus. Clinical and radiological evaluations revealed a fixed 130° equinus deformity and extensive midfoot and hindfoot destruction, consistent with Eichenholtz Stage III Charcot joint. The patient underwent a triple arthrodesis procedure, combining debridement, osteotomy, and internal fixation using cannulated and cancellous screws, along with autologous bone graft harvested from the iliac crest. Post-operative management included non-weight-bearing mobilization and casting in a plantigrade position. Radiographic follow-up at three months showed stable fusion, proper alignment, and no signs of implant failure. Clinically, the patient reported reduced pain and improved function, with the ability to perform daily activities with minimal assistance. This case highlights the importance of timely diagnosis and appropriate surgical intervention in advanced CN to prevent further deformity and preserve limb function. Triple arthrodesis proved effective in restoring foot alignment and achieving a stable, plantigrade foot. Patient compliance and individualized treatment planning, considering comorbidities, are crucial for optimal outcomes in managing Charcot arthropathy. Keywords: Charcot neuroarthropathy, triple arthrodesis, diabetes mellitus, hindfoot deformity.