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Foot Ankle Clin. 2016 Sep;21(3):595-627. doi: 10.1016/j.fcl.2016.04.012.

Neuropathic Minimally Invasive Surgeries (NEMESIS):: Percutaneous Diabetic Foot Surgery and Reconstruction.

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Department of Orthopaedics, Hairmyres Hospital, East Kilbride, Lanarkshire, UK; The London Orthopaedic Clinic, London, UK. Electronic address:


Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot. It may potentially reduce the risk associated with large wounds and bony correction in this patient group.


Charcot arthropathy; Charcot neuroarthropathy; Diabetes; Diabetic ulcer; Minimally invasive surgery; Neuropathic osteoarthropathy

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