Charcot Foot
What Is Charcot
Foot?
Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
Charcot foot is a very serious condition that can lead to
severe deformity, disability, and even amputation. Because of its seriousness,
it is important that patients with diabetes—a disease often associated with
neuropathy—take preventive measures and seek immediate care if signs or
symptoms appear.
Causes
Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk—making the injury worse.
Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk—making the injury worse.
People with neuropathy (especially those who have had it
for a long time) are at risk for developing Charcot foot. In addition,
neuropathic patients with a tight Achilles tendon have been shown to have a
tendency to develop Charcot foot.
Symptoms
The symptoms of Charcot foot may include:
The symptoms of Charcot foot may include:
·
Warmth to the touch (the affected foot feels
warmer than the other)
·
Redness in the foot
·
Swelling in the area
· Pain
or soreness
Diagnosis
Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the surgeon will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests may be ordered.
Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the surgeon will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests may be ordered.
Once treatment begins, x-rays are taken periodically to
aid in evaluating the status of the condition.
Non-Surgical
Treatment
It is extremely important to follow the surgeon’s treatment plan for Charcot foot. Failure to do so can lead to the loss of a toe, foot, leg, or life.
It is extremely important to follow the surgeon’s treatment plan for Charcot foot. Failure to do so can lead to the loss of a toe, foot, leg, or life.
Non-surgical treatment for Charcot foot consists of:
·
Immobilization. Because the
foot and ankle are so fragile during the early stage of Charcot, they must be
protected so the weakened bones can repair themselves. Complete
non-weightbearing is necessary to keep the foot from further collapsing. The
patient will not be able to walk on the affected foot until the surgeon
determines it is safe to do so. During this period, the patient may be fitted
with a cast, removable boot, or brace, and may be required to use crutches or a
wheelchair. It may take the bones several months to heal, although it can take
considerably longer in some patients.
·
Custom shoes and bracing. Shoes
with special inserts may be needed after the bones have healed to enable the
patient to return to daily activities—as well as help prevent recurrence of
Charcot foot, development of ulcers, and possibly amputation. In cases with
significant deformity, bracing is also required.
· Activity
modification. A modification in activity level may be needed to
avoid repetitive trauma to both feet. A patient with Charcot in one foot is
more likely to develop it in the other foot, so measures must be taken to protect both feet.
When is Surgery
Needed?
In some cases, the Charcot deformity may become severe enough that surgery is necessary. The Doctors of Hosey Foot and Ankle Centers will determine the proper timing as well as the appropriate procedure for the individual case.
In some cases, the Charcot deformity may become severe enough that surgery is necessary. The Doctors of Hosey Foot and Ankle Centers will determine the proper timing as well as the appropriate procedure for the individual case.
Preventive Care
The patient can play a vital role in preventing Charcot foot and its complications by following these measures:
The patient can play a vital role in preventing Charcot foot and its complications by following these measures:
·
Keeping blood sugar levels under control can
help reduce the progression of nerve damage in the feet.
·
Get regular check-ups from a foot and ankle
surgeon.
·
Check both feet
every day—and see a surgeon immediately if you notice signs of Charcot foot.
·
Be careful to avoid injury, such as bumping the
foot or overdoing an exercise program.
· Follow
the surgeon’s instructions for long-term treatment to prevent recurrences,
ulcers, and amputation.
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