WHAT IS IT?

Charcot foot, also referred to as a rocker bottom foot, is a progressive condition that affects the bones, joints, and soft tissue of the foot and ankle. Individuals with significant nerve damage may lose the ability to feel the sensations in their feet, leading to unrecognized trauma, which can lead to fractured bones, deformity, and amputation if not treated.

SYMPTOMS & DIAGNOSIS

Early diagnosis of Charcot foot is important to ensure successful treatment. X-rays and tests are performed to determine if the condition is present. The following symptoms are common to individuals affected by Charcot foot:

  • Swelling and redness present (commonly present in early stages)
  • Feet feeling warmer than normal
  • Loss of feeling in the foot
  • Pain or soreness
  • Dislocation
  • Arch collapse
  • Imbalance of soft tissues (muscles, tendons, ligaments)
  • Bone fractures

WE TREAT

Treating Charcot foot must be done very carefully by a highly trained foot and ankle surgeon, to ensure a successful outcome and minimize complications. It is important that the tissues involved in the injury are properly inspected as the condition develops uniquely in each patient. Because most Charcot foot cases occur in diabetic patients with neuropathy, daily monitoring and proper diet must be implemented. Treatment of Charcot foot will depend on the degree of severity and patient’s overall health status. Some diabetics may need evaluation of their circulation by a vascular specialist.

Treatment Options

Non-Surgical Treatment

Non-surgical treatment is available to those who are candidates. Interventions are necessary to prevent further complications, such as amputation.

IMMOBILIZATION

Keeping weight off the affected foot will allow the weakened bones and tissues to repair themselves, and prevent the foot from further collapse. Healing may take several months or more and the patient may be fitted with a cast or brace and have to use crutches or a wheelchair. It is important to remain immobile for this period as instructed.

CUSTOM SHOES & BRACING

As the bones consolidate during the natural phases of healing and the foot is still unstable, it is important to protect the structure so that it does not digress back. Custom shoe wear and protective bracing may be required to ensure proper care and prevent recurrence. Over the counter shoe wear will not protect the neuropathic foot, and may not fit if there is deformity.

ACTIVITY MODIFICATION

Due to risk of recurrence and developing Charcot Foot in both feet, preventative measures should be taken. Patients can monitor their daily activity level through skin temperature assessment, using a pedometer to track amount of steps taken per day, and using other means of technology for tracking.

Surgical Treatment

If a patient’s condition is severe enough, a highly specialized foot and ankle surgeon will determine the necessary timing, surgical procedure, postoperative footwear and long-term care for that individual.

Prevention

To prevent a Charcot foot from occurring or reoccurring, it is imperative that patients with neuropathy be aware of the signs and symptoms, check both feet daily, get regular check-ups from a foot and ankle surgeon, avoid trauma or injury to the lower extremities, and follow the surgeon’s instructions to avoid complications and risk of amputation.

  • BEFORE & AFTER

    Charcot Foot

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  • Charcot Foot

    Case 1

    Before

    After