CHARCOT FOOT: A serious complication of diabetes

How to protect Holiday diabetic feet
How To Protect Holiday Diabetic Feet
July 17, 2016

CHARCOT FOOT: A serious complication of diabetes

Charcot arthropathy, also known as Charcot foot is a serious and potentially limb-threatening lower-extremity complication of diabetes and it could develop if you have peripheral neuropathy in your feet.

Charcot foot can make the bones in your foot become fragile and fractures and dislocations of the bones and joints could occur with little or no known trauma.

Most patients with Charcot could not recall injuring their foot at all.

If you have loss of sensation (peripheral neuropathy) in your feet, you may still be able to walk on your foot with the injury without feeling any pain.

Having a lack of feeling in your feet makes it incredibly important to check your feet on a daily basis for any abnormalities.

Charcot arthropathy may affect any part of the foot and ankle, including the midfoot, hindfoot, ankle, heel and forefoot and multiple areas may be involved at the same time.

Fractures and dislocations frequently involve several bones and joints, which could lead to the classic rocker-bottom foot deformity in the later stage of the syndrome.

Early recognition and management is important to avoid the rocker-bottom deformity because once this has occurred, your foot will not return to normal.

How to recognise Charcot foot

The early signs of a Charcot foot are frequently mild in nature, but can become much more obvious with repetitive trauma.

The affected area of the foot may show swelling and warmth and there may be some redness, which is sometimes mistaken for infection.

Due to nerve damage (peripheral neuropathy) there is usually no pain, however, this is not always the case.

In most cases, only one foot is affected, however, in some rare cases Charcot foot can develop in both feet, although not at the same time.

X-Rays are the primary initial imaging method for assessing the foot and they provide information on bone structure, alignment, and mineralization.

X-rays can show subtle fractures and dislocations or later show more definite fractures and subluxations.

Charcot foot can be a serious condition and can be difficult to diagnose, manage and treat.

It is very important if you experience any of these symptoms to see your podiatrist, diabetic foot specialist or a medical health care professional as soon as possible.

The aim of treatment

There are 2 important aims of treating Charcot Foot: Charcot foot

  1. Preventing a permanent change to the shape of your foot.
  2. Preventing future foot problems.

Offloading at the acute active stage of the Charcot foot is the most important management strategy and could arrest the progression to deformity.

This usually occurs by applying a plaster cast to the affected foot, which is initially replaced in 3 days and then checked each week.

A cast walker with a prescription insole is another device that can also be used to offload the foot.

The casting is continued until the swelling has gone and the temperature of the Charcot foot is within 2°C of the unaffected foot.

If possible, the use of crutches or a wheelchair should be encouraged to avoid weight bearing on the affected side.

Surgical treatment of Charcot arthropathy of the foot and ankle is based primarily on expert opinion.

Surgery is generally advised for removing infected bone and removing bony areas that could not be accommodated with therapeutic footwear or custom orthoses.

How you can help your condition:

  • Follow the advice given by your medical specialist treating you.
  • Keep your weight off your foot as much as possible.
  • Keep your diabetes under control (get help from your doctor and nutritionist if you are struggling with this).
  • Monitor your other foot as there will be more pressure on it and this could cause further problems.
  • Contact your specialist if you notice any changes or have any concerns.

What to do when your condition has settled down:

Even after you have had treatment, there may be some changes to the shape of your foot.

These changes may cause higher pressure areas on certain parts of your foot, possibly leading to callous formation which could result in ulcer formation if the pressure is not relieved.

You may need to manage the hard skin and these newly acquired high pressure areas with custom made orthotics from your podiatrist or prescription footwear from an orthotist, depending on the severity of the deformity.

Checking your feet DAILY plays an important role in your health and wellbeing when you have diabetes.

By keeping a close eye on your feet can help you to prevent complications from occurring as a result of diabetes.

 

If you have any questions or have experienced Charcot foot yourself, let us know your story in the comments box below.

mm
Founder of footality.com and fruitbatsocial.com. Podiatrist and Chief Foot Health Inspiration Officer (CFHIO). Travel and yoga are just a few of my passions.