Charcot Foot
Charcot foot is a condition characterized by severe fracturing of the foot in patients with significant pedal nerve damages. Due to the lack of feeling in the foot from nerve damages, even as the fracture occurs, the patient will continue to walk on it. This causes further bone fractures, and eventual joint collapse. Ultimately, the foot arch collapses, and becomes a rocker bottom foot.
Charcot foot is a serious condition that often leads to severe deformity, disability, and possible amputations. Patients should seek immediate medical care if signs of Charcot foot appear.
Causes:
Diabetes is a common cause of neuropathy, the loss of feeling in the foot. Other causes of neuropathy include vitamin deficiencies, trauma to nerves, medications, infections, and inherited disorders. In addition, a tight Achilles tendon has been shown to increase the pressure of the foot, accelerating the development of Charcot foot.
Symptoms:
The symptoms of Charcot foot include the following:
Diagnosis:
Careful examination of the foot, with an in-depth history relating to the onset of the symptoms is important. To assess the severity of the bone fracture and joint collapse, X-rays of the foot can be ordered. Other advanced imaging such as CT scan can also further evaluate the condition of the bones and joints.
Treatment:
The appropriate treatment for Charcot foot should start as soon as diagnosis is made. Non-surgical treatments include the following:
Surgery is necessary if the deformity is severe. Timing of the surgery after the initial deformity must be considered. The type of surgery will be assessed on an individual basis
Charcot foot is a condition characterized by severe fracturing of the foot in patients with significant pedal nerve damages. Due to the lack of feeling in the foot from nerve damages, even as the fracture occurs, the patient will continue to walk on it. This causes further bone fractures, and eventual joint collapse. Ultimately, the foot arch collapses, and becomes a rocker bottom foot.
Charcot foot is a serious condition that often leads to severe deformity, disability, and possible amputations. Patients should seek immediate medical care if signs of Charcot foot appear.
Causes:
Diabetes is a common cause of neuropathy, the loss of feeling in the foot. Other causes of neuropathy include vitamin deficiencies, trauma to nerves, medications, infections, and inherited disorders. In addition, a tight Achilles tendon has been shown to increase the pressure of the foot, accelerating the development of Charcot foot.
Symptoms:
The symptoms of Charcot foot include the following:
- Warmth. One foot is usually warmer than the other foot
- Redness
- Swelling
- Pain or soreness. Despite nerve damages to the foot, some patients can experience pain and soreness during Charcot foot development.
Diagnosis:
Careful examination of the foot, with an in-depth history relating to the onset of the symptoms is important. To assess the severity of the bone fracture and joint collapse, X-rays of the foot can be ordered. Other advanced imaging such as CT scan can also further evaluate the condition of the bones and joints.
Treatment:
The appropriate treatment for Charcot foot should start as soon as diagnosis is made. Non-surgical treatments include the following:
- 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 weight bearing is necessary to keep the foot from further collapsing. The patient will not be able to walk on the affected foot until the foot and ankle specialist determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot or brace. Patient may be required to use crutches or a wheelchair to assist with non-weight bearing to the affected foot. It take the bones several months to heal, although in some cases, it can take considerably longer in some patients.
- Custom shoes and bracing. Shoes with special inserts may be required 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.
Surgery is necessary if the deformity is severe. Timing of the surgery after the initial deformity must be considered. The type of surgery will be assessed on an individual basis