Orthopedics · Inflammatory and Metabolic Arthropathy — Orthopedic Management

Charcot (neuropathic) arthropathy at the tarsometatarsal (Lisfranc) joint level in a patient with longstanding diabetes mellitus is best classified using:

  • A Eichenholtz staging (stages 0, I, II, III — development, coalescence, reconstruction)
  • B Wagner-Meggitt wound classification
  • C Texas University classification
  • D Brodsky anatomical pattern (Type 1, 2, 3)
Correct answer: A. Eichenholtz staging (stages 0, I, II, III — development, coalescence, reconstruction)

Explanation

The Eichenholtz classification is the standard staging system for Charcot neuroarthropathy: Stage I (acute fragmentation — warm, swollen foot with bony destruction), Stage II (coalescence — decreased osteoclast activity, reparative phase), Stage III (reconstruction — sclerosis and fusion). Stage 0 (prodromal — warm swollen foot with no radiographic changes, but positive MRI) was added later. This staging guides management: Stage I requires total contact casting and non-weight-bearing; only Stage III (quiescent) is suitable for reconstructive surgery. Brodsky (D) is the anatomical distribution system.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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