Background: A 61-year-old man with type 2 diabetes mellitus presented to a diabetic foot clinic 1 year after he injured his left foot in a slip injury. Examination showed collapse of the longitudinal arch with a rocker bottom deformity and a plantar ulcer under the plantar midfoot bony prominence.
Investigations: Radiographs of the foot.
Diagnosis: Diabetic Charcot arthropathy with rocker bottom deformity and plantar midfoot ulcer.
Management: The ulcer was initially treated by debridement and immobilization. Subsequently, the patient underwent surgery that consisted of plantar midfoot ostectomy to remove the bony prominence that had caused the ulcer, and midfoot osteotomy with realignment arthrodesis to reconstruct the longitudinal arch.