What is the cornerstone treatment for Charcot-Marie-Tooth disease?

• A. Triple arthrodesis
• B. Ankle fusion
• C. Tarsometatarsal fusion
• D. Excision of bones

Answer: (A)

Stabilizing a severely deformed, neuropathic hindfoot to a plantigrade, pain-free position is the goal. In Charcot‑Marie‑Tooth with progressive hindfoot collapse, fusing the hindfoot joints—subtalar, talonavicular, and calcaneocuboid—provides a definitive solution by creating a single solid lever arm that resists deforming forces. This triple arthrodesis addresses the joints most responsible for instability and deformity, improving alignment, pain, and shoe fit, which is why it’s considered the cornerstone. Fusing only the ankle joint fails to control hindfoot malalignment; fusing a midfoot joint or excising bone does not adequately stabilize the hindfoot and would not correct the primary instability.