Treating Charcot Foot: Surgery or Not?

Treating Charcot Foot
If you have peripheral neuropathy, there’s a chance you could also develop Charcot foot. This condition weakens the bones of your foot, as well as your joints and soft tissues, while causing painful sores or changing the shape of your foot.

As many as 2.5 percent of patients with diabetes can develop Charcot foot, and it can recur in as many as five percent of cases.

Fortunately, your doctor can help you in treating Charcot foot, largely reversing the damage it causes. Depending upon the severity of your case, you could receive medical or surgical therapy. Any treatment option you receive will have similar goals: take weight off the injured foot, address bone disease, and prevent future foot fractures.

Charcot Foot Diagnosis 

Imaging scans can help your doctor determine what treatment type you need. X-rays offer detailed pictures of dense structures, such as bones. MRI and ultrasound provide good imaging of foot and ankle soft tissues, potentially identifying any bone infections. Bone scans are nuclear tests that can also identify bone infections. A specific test — an indium scan — tags your white blood cells and follows them to the infection site.

Treating Charcot Foot

Whether your doctor recommends surgical or non-surgical treatment, you will get the best long-term results if you closely follow your physician’s instructions. Most specifically, wait until he or she tells you it’s safe to put weight on your foot again.

Also, be sure to check your feet daily for any problems, including scrapes or lingering sores. If any exist, immediately contact your doctor. The sooner you get treatment, the more likely you are to have a good outcome.

Non-surgical treatment: Offloading — keeping your weight off your affected foot — is the most important part of treating Charcot foot without surgery. For anywhere from 8-to-12 weeks, you’ll wear a protective walking boot or cast. The protective footwear should stay in place until any redness, swelling, or heat disappears. The Charcot Restraint Orthotic Walker (CROW) is a commonly used device.

The second step is prescription orthotic shoes. These shoes must fit appropriately, providing enough room for your toes and enough cushioning for the heel, arch, and ball of your foot. The right shoes won’t have any pressure points, reducing the risk of injury or ulcers.

You’ll also need to change your activities to avoid repetitive trauma to both feet.

Surgical treatment: Surgery is recommended for individuals with severe ankle and foot deformities that could make using a brace or other orthotics difficult. These patients are also at a higher risk for developing foot ulcers.

Surgery could involve re-aligning the bones of your foot or removing some that could cause ulcers. According to recent research, most patients with diabetes are able to resume normal walking after surgery.

Because infection risk is high post-surgery, you’ll be instructed not to put your full weight on your foot until your doctor gives you the green light. You’ll also need to commit to wearing protective footwear for life.

Remember, it is possible for Charcot foot to return, so stay vigilant with your foot hygiene.

For more information on treating Charcot foot, contact the Amputation Prevention Centers of America.

Protect Yourself from Charcot Foot

Charcot Foot

If you have diabetes, you face the possibility of developing many foot problems, including ulcers, non-healing sores, and even amputation. But, there’s another condition you should know about and watch out for: Charcot foot.

Also called Charcot arthropathy, this condition weakens the bones in the feet of people who have peripheral neuropathy. It also attacks the joints and soft tissues. Over time, it can cause painful sores and actually change the shape of your foot.

Why does Charcot foot happen?

Your bones naturally lose calcium when injured, and, according to the Cleveland Clinic, that makes the bones weaker and more susceptible to further damage. The numbness from peripheral neuropathy increases the danger. If you can’t feel a sprain, a break, or an infected or lingering sore, you’re more likely to continue walking on your foot normally. In some cases, slow healing from a foot surgery can be responsible.

What happens?

Prompted by injury that often doesn’t get timely treatment, your bones lose the calcium that keeps them strong. At that point, your foot can start to lose its shape, and your arch can drop below your toes or heel. Doctors often call this “rocker bottom.”

Additionally, your toes might curl, and your ankle can become twisted and unsteady. Any misshapen bones can also press against your shoes, creating new sores that can also get infected and lead to amputation.

What to look for?

Diagnosing Charcot foot can be difficult, according to a study published in American Family Physician, because it mimics other conditions, including cellulitis and blood clots. Initial X-rays and lab tests can also often look normal.

However, there are some symptoms, other than the fallen arch, that can make you suspect Charcot foot. If your foot becomes reddish, warm to the touch, or swollen, talk with you doctor. You should also be concerned if you have instability in your ankle, any misalignment of the bones that form the joint, or a strong pulse in your foot.

Can you prevent it?

Yes, you can do things to potentially side-step Charcot foot. Follow this list for better foot health:

  1. Get regular check-ups with a foot doctor who has experience treating diabetic foot problems.
  2. Check your feet daily for swelling, redness, warm spots, and sores. Check between your toes, too.
  3. Wash your feet daily, and dry them thoroughly.
  4. Always wear socks and shoes.
  5. Keep your blood sugar levels under control — between 80-130 mg/dL before eating, under 180 mg/dL after.
  6. Take extra care to avoid injury, particularly while exercising.

 
Overall, if you begin to see these changes in your feet — especially if your foot begins to change shape — contact your doctor immediately. Any delays can result in further damage to your foot that could lead to infection or amputation.

For questions, please contact Amputation Prevention Centers of America.