What is charcot foot?
Charcot foot is a serious condition that can lead to severe deformity of the foot, disability and even amputation. It can occur in patients living with diabetes. Long standing diabetes can cause neuropathy or damage to the nerves of the leg and foot. Neuropathy leads to gradual weakening of bones of the foot leading to fractures. When a patient continues to walk on a weakened and fractured foot, the foot changes in shape. As the joints and bones collapse the foot may take a rocker bottom appearance making it prone to develop ulcers and infection.
What causes a charcot foot?
Charcot foot develops as a result of neuropathy which causes decrease in sensation and ability to feel temperature, pain or trauma. Due to diminished sensation, the patients continue to walk on a foot with weakened bones and unstable joints. This leads to deformity of foot and predisposes the foot to ulceration and infection. Patients with diabetes and tight achilles tendon (calf muscles) are prone to develop charcot foot and foot ulcers.
The initial symptoms of charcot foot include:
1- Diffuse swelling of foot
2- Redness.
3- Warmth to touch.
4- Soreness or pain.
You should consult a doctor specialising in foot and ankle upon encountering these symptoms. Early diagnosis can help cure charcot foot and prevent the development of ulcers or leading to amputation.
What are the treatment options?
Treatment of charcot foot include non surgical and surgical options. The doctor will recommend treatment according to your symptoms and stage of the disease.
Non-surgical treatment:
These include:
1- Immobilization:
During the early stages, the bones of the foot and ankle are fragile and need to be protected so that the bones can repair themselves. Being completely non weight bearing is necessary to prevent the foot from collapse. It can take the bones several months to heal.
2- Total contact cast, braces and shoes:
During the period of swelling, plaster cast is applied covering the entire foot and ankle. This decreases the movement of the foot and ankle joints and helps to reduce the swelling. The cast is usually changed at weekly or shorter intervals initially till the swelling is completely reduced. Once the swelling subsides, specially designed custom made braces are worn by the patient to enable them to return to daily activities. This also prevents recurrence of charcot foot, development of ulcers and possible amputation.
3- Activity modifications:
Activity modification may be recommended to avoid repetitive trauma to the feet and protect both the feet.
When is surgery needed?
If the severity of the deformity is so severe that the patient is always at risk of developing ulcers or the patient is unable to continue wearing braces and customized shoes, surgery may be recommended. The surgery aims to realign the fused bones and stabilize the affected foot. The surgeon may also restructure edgy bones that are likely to cut through the skin and cause sores. Surgery is usually safe and does not involve major risks.
In conclusion,a serious condition like charcot foot can lead to disability, severe deformity and even amputation. It is essential for diabetics to seek immediate treatment and take preventive measures if symptoms of the same appear.