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Total contact casting
38%
631/1680
Arthrodesis
50%
835/1680
Open reduction and internal fixation
2%
33/1680
Bed rest
1%
10/1680
Standard walking boot
10%
161/1680
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The radiograph shows Charcot changes in the subtalar joint. In the absence of gross deformity, the initial treatment is nonsurgical, consisting of total contact casting, with frequent cast changes and progression to weight bearing when swelling subsides and early consolidation is seen radiographically. A walking boot will not provide sufficient immobilization, whereas bed rest carries the risk of significant deconditioning in an otherwise active patient with well-controlled diabetes. Surgery as the initial treatment is not indicated in the absence of gross deformity or ulceration.
1.6
(65)
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