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Charcot Foot

Diabetes can cause a series of problems for your feet. One of the most critical conditions is known as Charcot foot. Though it commonly goes unrecognized, particularly in the acute phase, severe complications can occur as it advances. 

Charcot foot is a progressive condition that involves the gradual weakening of bones, joints, and soft tissues of the foot or ankle. Charcot foot is a severe complication of diabetes and is caused by peripheral neuropathy (nerve damage) in which the person’s foot or ankle becomes insensitive to pain. The condition is thought to be caused by repetitive injury, typically a series of microtraumas that a person may only be minimally or even completely unaware of.

As Charcot foot progresses, the bones can become so weakened that they fracture. Joints may dislocate in the foot or ankle. With repetitive trauma and degeneration, the joints in the foot may eventually collapse, causing the foot to become deformed and take on an abnormal shape such as a rocker-bottom appearance

Symptoms include:

  1. Dislocation of the joint

  2. Heat

  3. Insensitivity in the foot

  4. Instability of the joint

  5. Redness

  6. Strong pulse

  7. Swelling of the foot and ankle 

  8. Subluxation (misalignment of the bones that form a joint)

Because of its seriousness, it is important that patients living with diabetes—a disease often associated with neuropathy—take preventive measures and seek immediate care if signs or symptoms appear.

Preventive Care

The patient can play a vital role in preventing Charcot foot and its complications by taking the following measures: 

  1. Keeping blood sugar levels under control– this can help reduce the progression of nerve damage in the feet

  2. Get regular check-ups– contact us today to schedule an appointment so that we can provide you with the necessary care

  3. Inspect both feet every day– see a surgeon right away if you notice signs of Charcot foot (warmth to the touch, redness in the foot, swelling in the area, pain or soreness)

  4. Be careful to avoid injury– bumping the foot or overdoing an exercise program can aggravate the problem

Non-surgical and Surgical Treatments for Charcot foot

Though diabetic patients should use these preventative measures, sometimes it is necessary for non-surgical and even surgical treatments for Charcot foot. 

Listed below are possible non-surgical treatment: 

  1. Immobilization: because the foot and ankle are so fragile during the early stages of Charcot foot, they must be protected so the weakened bones can repair themselves. During this period, no weight should be placed on the foot. It may take the bones several months to heal, but immobilizing the foot is crucial.

  2. Custom shoes and bracing: shoes with special inserts may be needed after the bones beal so that the patient can return to daily activities. This can also prevent the recurrence of Charcot foot and the development of ulcers.

  3. Activity modification: the modification in activity may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop the condition in the other foot, so measures should be taken to protect both feet. 

In some cases, the Charcot deformity may become severe enough that surgery is necessary. Surgical options may include realignment osteotomy and fusion (correction of deformity), or ostectomy (removal of bony prominence that could cause an ulcer).

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