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The mean age of the patients was 62.6 years (46 to 83); their mean BMI was 32.7 (15 to 47) and their median American Society of Anaesthetists score was 3 (2 to 4). All presented with severe deformities and 15 had chronic ulceration. All were treated with reconstructive surgery and seven underwent simultaneous midfoot fusion using a bolt, locking plate or a combination of both. At a mean follow-up of 26 months (8 to 54), limb salvage was achieved in all patients and 12 patients (80%) with ulceration achieved healing and all but one patient regained independent mobilisation. There was failure of fixation with a broken nail requiring revision surgery in one patient. Migration of distal locking screws occurred only when standard screws had been used but not with hydroxyapatite-coated screws. The mean American Academy of Orthopaedic Surgeons Foot and Ankle (AAOS-FAO) score improved from 50.7 (17 to 88) to 65.2 (22 to 88), (p = 0.015). The mean Short Form (SF)-36 Health Survey Physical Component Score improved from 25.2 (16.4 to 42.8) to 29.8 (17.7 to 44.2), (p = 0.003) and the mean Euroqol EQ\u20115D\u20115L score improved from 0.63 (0.51 to 0.78) to 0.67 (0.57 to 0.84), (p = 0.012). <\/jats:p><jats:p> Single-stage correction of deformity using an intramedullary hindfoot arthrodesis nail is a good form of treatment for patients with severe Charcot hindfoot deformity, ulceration and instability provided a multidisciplinary care plan is delivered. <\/jats:p><jats:p> Cite this article: Bone Joint J 2015;97-B:76\u201382. <\/jats:p>","DOI":"10.1302\/0301-620x.97b1.34542","type":"journal-article","created":{"date-parts":[[2015,1,7]],"date-time":"2015-01-07T23:06:53Z","timestamp":1420672013000},"page":"76-82","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":83,"title":["Outcome of one-stage correction of deformities of the ankle and hindfoot and fusion in Charcot neuroarthropathy using a retrograde intramedullary hindfoot arthrodesis nail"],"prefix":"10.1302","volume":"97-B","author":[{"given":"M.","family":"Siebachmeyer","sequence":"first","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation\rTrust, London SE5 9RT, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Boddu","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation\rTrust, London SE5 9RT, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bilal","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation\rTrust, London SE5 9RT, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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