Charcot Foot

Charcot foot (of the foot or ankle), also called Charcot Neuroarthropathy, is a condition that causes weakening of the bones, which can occur in people with significant nerve damage (neuropathy). Those with diabetes are at higher risk for developing this serious condition. With this condition, the bones weaken enough to fracture. With continued walking, the foot eventually changes shape. As this occurs, the foot and ankle have a high risk for skin breakdown or ulceration, which can lead to infections. Charcot of the foot and ankle is a very serious condition as it may lead to severe deformity, disability, or even worse, amputation. Having this serious condition of one limb puts a person at increased risk of developing it in the other.

Symptoms of Charcot Foot 

Evaluation, treatment and preventative measures should be taken immediately if any of the following symptoms occur related to Charcot foot: 

- Warm to the touch (the affected foot may feel warmer than the other) 

- Red 

- Swollen 

- Pain or soreness in the affected foot 

Causes of Charcot Foot 

Charcot foot develops because of neuropathy, which decreases a person’s ability to feel sensations of pain, temperature, or trauma. A person may continue to walk due to diminished sensation, thus making the injury worse. Those who have suffered from neuropathy for an extended period are at risk for developing Charcot foot. A shortened Achilles tendon can also be a risk factor for the development of Charcot foot. 

Treatment for Charcot Foot 

Non-Surgical Treatment Options for Charcot Foot 

- Immobilization – A patient may need to wear a cast, removable boot, or brace, in addition to using a wheelchair or crutches. 

This allows the fragile bones in the foot and ankle to heal. 

- Custom shoes and bracing – Custom shoe inserts may be needed after the bones heal to prevent Charcot foot from 

reoccurring. Custom braces may be needed to resume normal function in severe cases. 

- Activity modification – To prevent reoccurrence, a patient may need to reduce their activity level and make lifestyle 

modifications. 

Surgical Treatment for Charcot Foot 

For serious deformity resulting from Charcot foot, surgery may be necessary. 

- Exostectomy – If a bony prominence is present (with or without ulcerations), removal of the prominence may be necessary. - Reconstruction – In situations where the foot is unbraceable or in the case of chronic, non-healing ulcers, reconstruction may be necessary, Charcot reconstruction is performed. It is critical that this procedure be performed by a surgeon specifically trained in Charcot reconstruction with training in external fixation. - Amputation – Reserved for the most severe cases only when the foot is unsalvageable due to abscesses, infection or extensive bone loss. 

Charcot foot is a very serious condition and it’s important to seek treatment from a physician with experience in treating it. Dr. Flynn is a fellowship-trained foot and ankle surgeon with experience both treating Charcot foot conservatively and in surgical procedures, when necessary. Again, for the best possible outcome, early treatment for Charcot foot is very important.