We explored whether skin temperature, measured with an infrared thermometer, is useful in managing Charcot fractures. Seventy patients with active Charcot fractures were enrolled. Of these, 64 were excluded from further analysis because of factors deemed likely to confound skin temperature measurement, i.e. most skin lesions. Radiographs were obtained using a standardized weight bearing protocol and interpreted by formal criteria. Patients were treated with a walking total contact cast for approximately 6 months and PTB bracing thereafter. The temperature of the affected feet was elevated compared to the contralateral feet at presentation (difference of 4.25 ± 1.63°C). This decreased on average at 0.022°C/day (r = 0.5), giving an intercept of 0°C difference at 147 ± 75 days. However, there was too much variability in the individual data even in these highly selected patients to give any correlation between skill temperature and radiographs in individuals. Radiographic worsening ended by 3-6 months. Radiographic healing began by 3-6 months and continued after the change from casting to bracing. We conclude that skin cooling occurs with treatment of active Charcot fractures, but many patients have other events that confound skin temperature measurement, and even in patients without such confounding factors individual skin temperatures are too variable to be clinically useful.
All Science Journal Classification (ASJC) codes
- Orthopedics and Sports Medicine