In March 1986, a 33-year-old man sustained a spinal fracture resulfing in cauda equina paresis. He subsequently injured his right foot in May 1991. Roentgenograms revealed an oblique fracture of the distal shaft of the first metatarsus without displacement. After 1 month in a plaster cast, roentgenograms showed an indistinct fracture line. Immobilization was discontinued and the foot was loaded gradually. The noted swelling on the dorsum of the foot and 2 months afoer the accident roentgenograms showed an abnormal shadow around the first tarsometatarsal joint. The patient was referred to our hospital and admitted for operation. Arthrodesis of the first tarsometatarsal joint with plate and inlay bone graft using an iliac bone was performed following a diggnosis of Charcot arthropathy. The the patient was Neated by immobilization do a plaster cast for 5 weeks. Bone union was detected with roentgenograms 2.5 months after the operation, The plate was extracted 9 months after the operation. Thirteen months after the first operation roentgenograms showed good healing and the patient remairs asymptomatic.
