Charcot Foot refers to a progressive foot deformity that occurs as a result of nerve dysfunction or damage. This causes the bones in the foot joint to become so weak and brittle that they may be easily dislocated or fractured. Weight-bearing and walking further pressurizes the foot, causing it to change its shape. This may lead to permanent disability.
Charcot Foot is mainly observed in people suffering from Diabetes. However, it may also affect people suffering from Leprosy or Syphilis. The condition has a high probability of reoccurring even after treatment and is therefore considered to be a lifelong impairment.
Causes
- Neuropathy- Damage to the nerve endings causes inability to sense pain, change in temperature or external injury, making the condition worse
- Inherent structural problems- People who have a tight Achilles tendon are at a greater risk of developing Charcot Foot
- Continuing to walk or put weight on the foot after an injury may be a reason as it adversely affects the joint stability
- Repeated micro trauma or injuries which may go unnoticed can result in this syndrome over a period of time
- Past fractures or dislocations which have not been healed properly may cause Charcot Foot
Symptoms
- The affected foot may feel slightly warm to touch
- Pain and soreness
- Swelling and redness may occur
- The mid foot arch may collapse completely as the condition progresses
- Change in gait
- Some people may develop ulcers as the bone and the skin covering it are constantly stressed
- Bone infection, in severe cases
Diagnosis
- The orthopedic doctor may conduct a setailed clinical examination of the affected foot and ankle
- Analysis of the patient’s medical history, past injuries, family history etc. to identify the cause
- X-ray imaging may be recommended to get a detailed view of the changes in the bone structure
- CT scan and MRI may help in diagnosing damage and condition of the soft tissue structures that support the foot joint
- Blood tests may be conducted to monitor the sugar levels and check for any infections
Treatment
Charcot Foot can be treated both surgically and through conservative methods. These may include one or more of the following:
- Wearing a protective removable brace or splint on the affected foot
- Specific orthotic devices or shoe inserts may be used to support the foot and prevent further damage
- Weight bearing should be reduced or completely avoided in severe cases. Lifestyle and activity modification may be required to prevent further damage
- Surgery to remove the bony outgrowth that may result in ulcers and skin injuries. This procedure is called ostectomy
- Foot amputation may be done in severe cases of Charcot foot
- Surgical alteration of the tight Achilles tendon to reduce pressure on the foot
- Surgical removal of the damaged parts of tissues and bones to relieve pressure within the joint
- Bone graft or fusion may be done to correct structural deformities
- Physical therapy may be recommended post treatment to help the patient regain mobility
- Crutches or walker may be used to avoid weight bearing on the foot
