Radiodensity Analysis of Lateral Column Superconstruct Fixation Sites in Midfoot Charcot Neuroarthropathy

Dominick J. Casciato, Ryan Stone, John Thompson, Marissa Venero, Michael Chiu, Jonathan Blum, Ian Barron, Christopher Hyer

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Lateral column deterioration and subsequent loss of function poses a challenge for limb preservation in patients with Charcot neuroarthropathy (CN). Application of “superconstructs” provides stability and clinical improvement to an often-ulcerated lateral foot. This study examines radiodensity in Hounsfield units (HU) to compare bone quality of lateral column fixation targets using computed tomography (CT) scans between patients with and without midfoot CN. A retrospective chart review identified control (nondiabetic, non-CN; n = 29) and midfoot CN (n = 21) groups. Patient demographics and medical history were collected. Two reviewers measured the mean HU of circular regions of interest centered on the fourth and fifth metatarsal heads as well as the anterior, middle, and posterior thirds of the calcaneus. Radiodensity was compared between groups, among calcaneal locations, Eichenholtz stages and Brodsky types. A p value ≤.05 was considered statistically significant. Age and body mass index were not significantly different between groups. The CN group exhibited greater HU than the control group at the metatarsal head and calcaneus (p <.001). The anterior calcaneus exhibited greater HU than the posterior calcaneus in the CN group (p =.02). The difference in HU was not statistically significant between Stages 0-1 and Stages 2-3 or midfoot Brodsky Types. Indirect bone density analysis revealed an increased density in CN compared to control patients with no significant difference between midfoot CN stages or types. The anterior calcaneus was the densest rearfoot bone among the CN patients, a result that may have implications in surgical fixation.

Original languageEnglish (US)
Pages (from-to)377-381
Number of pages5
JournalJournal of Foot and Ankle Surgery
Issue number2
StatePublished - Mar 1 2023
Externally publishedYes


  • 3
  • Hounsfield units
  • beaming
  • bone density
  • deformity
  • diabetic neuropathy
  • nailing
  • neuroarthropathy
  • osteoarthropathy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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