There’s no shortage of potentially unpleasant foot problems that are linked to diabetes, but one of the most serious and destructive—by far—is Charcot foot. In this condition, the patient may fracture one or more bones in the foot without realizing it, and by continuing to walk compounds the damage: severe bone breaks, sores and wounds, dislocated joints, and a deformed appearance.
This condition can arise as a consequence of two others common among those with diabetes: low circulation and neuropathy. The lack of blood flow weakens bones and impairs healing, while severe neuropathy severs the link between pain receptors and your brain—even a severe fracture or puncture may not be felt.
Early detection and treatment for this condition produces the best outcomes. That’s the case with any foot or ankle condition, of course, but with Charcot foot the variation is particularly extreme.
In the early stages—redness and swelling may be present, but no or only very mild deformity—conservative therapies can save the foot from further damage. It’s extremely critical, however, that no weight is put on the feet and the broken bones and joints are given adequate time to heal. That means a cast or special boot and use of a device such as a knee walker, crutches, or wheelchair. The healing process can be slow—3 months is not uncommon—but mandatory to accomplish a successful recovery. We may also recommend diabetic shoes to protect your feet once you’re cleared for activity.
If the deformity is noticeable, especially if it puts you at high ulcer risk or joints are more unstable, surgical treatment will likely be necessary. Procedures and success rates vary significantly depending on the location and extent of the damage and deformity. While more stable cases may require only shaving a bony prominence or lengthening of soft tissues, unstable or ankle deformities may require more extensive cutting, repositioning, and/or fusing of bones, along with plating and screws to hold joints in place. There’s also a higher risk that, even if surgery is performed perfectly, severe Charcot foot involving significant bone damage (especially in the ankle) ultimately may not heal properly and will require an amputation. Like we said—don’t wait until your condition reaches this level to seek help!
With any procedure, it is critically important that you follow all instructions carefully and avoid putting weight on the foot too early. With an excellent surgeon, disciplined aftercare, and a little luck, patients with even severe Charcot foot have been able to save their feet and return to activity. But putting pressure on the foot too early can cause even a “relatively” minor one to unravel.
If you suffer from diabetes and notice any issues with your foot, don’t wait—give us a call right away. You can make an appointment with Family Foot & Ankle Center at one of our six Greater Cincinnati locations by dialing 888-689-3317.