Charcot neuropathic osteoarthropathy is a severe complication of diabetic neuropathy. Even today the disease is difficult to recognize and treat. While in the early stages conservative therapy is extremely efficient and avoids progression into more advanced phases, when there are structural deformities and osteoarticular alterations, surgery often takes on the role of limb salvage therapy. Within this scenario, we take into consideration the physiopathology and anatomical/functional conditions that support the indication for surgery. In this paper, we review the surgical techniques, both in the field of reconstructive and prophylactic surgery aiming at correcting deformity and instability before ulcerative lesions onset, and in the field of emergent surgery once there is a complicated condition due to osteomyelitis in the bone structures.
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