Rafting Screw Technique for Charcot Midfoot Reconstruction

Charcot foot, a debilitating neuroarthropathy of the foot and ankle, can be catastrophic for patients who experience the condition. Adequate treatment is crucial to restoring and preserving function and pain management in these patients. Several treatment approaches are described in the current literature, one of which is the beaming screw technique. This technique can result in numerous undesirable outcomes and complications, including iatrogenic metatarsal fracture, adduction and supination of the forefoot, and screw failure. Here, we present a novel “rafting screw” approach that has the capacity to avoid these complications while achieving the desired arthrodesis. This approach can reduce strain on the physician and improve patient outcomes. We describe the intraoperative technique and postoperative management. We also discuss the results of this approach seen in practice, including the few complications we have experienced.