The Center for Podiatric Care and Sports Medicine

Incidents of Charcot Foot in Diabetics Increasing, but New Treatments Show Promise

Posted by on Monday, July 27th, 2015

Share:

A couple of years ago, we reported that Charcot foot — a weakening of the foot bones that leads to deformity — was evident in up to 2.5% of the diabetic population. Amazingly, though, researchers believe this number could actually be much higher — as many as 1 in every 1,000 diabetes patients could be dealing with undiagnosed symptoms. A new article published in Diabetic Medicine explains that Charcot foot remains “neglected” because it is not a condition traditionally “emphasized in medical training.”1http://onlinelibrary.wiley.com/doi/10.1111/dme.12754/full However, we are very familiar with all the various neuropathies and disorders associated with diabetic foot care here at our NYC podiatrist office. While Charcot foot rates may be increasing, there are new techniques available that offer greater hope for mobility.

charcot foot treatment
The Ilizarov apparatus is now being used to improve mobility in morbidly obese patients being treated for Charcot foot. Image source: Wikimedia CC

New Technique Yields Better Results For Diabetics With Charcot Foot

Charcot foot is a scary complication because it often lands people in wheelchairs and may even lead to amputation in the worst case scenario. Loyola University Medical Center surgeon Michael Pinzur says he’s developed a treatment that enables 91% of his patients to walk normally again.2http://www.loyolamedicine.org/news/charcot-foot-operations-help-diabetes-patients-walk-normally-again-05272015 This new technique involves securing the foot bones to an external fixation device made of stainless steel and aircraft-grade aluminum. Dr. Pinzur alone has done over 560 such operations with great success.

The good news is that New Yorkers needn’t travel to Illinois to receive the best care for Charcot foot and diabetes-related foot complications. Our board-certified podiatric surgeons in Manhattan and Westchester are familiar with external fixation surgeries and have extensive experience operating on the most complex foot traumas and disfigurements. We are current on all the latest proven surgical techniques to restore mobility and reduce the risk of future foot problems.

Treating Morbidly Obese Patients With Charcot Foot

In the past, doctors have had difficulty treating the morbidly obese with traditional surgical techniques for Charcot foot. The heavy weight caused bones to heal in deformed positions, even when the leg was put in a cast. Patients were required to remain in a wheelchair for up to nine months and wear cumbersome leg braces for heavy duty support afterward. Dr. Pinzur popularized the use of a device called the Ilizarov circular external fixator. For 10-12 weeks, the patient wears a device containing three rings that surround the foot and lower calf and secure pins to the bones after surgery. Patients are able to walk and bear weight during their recovery. A walking cast is worn for about a month after the device comes off. From there, most patients will move to a walking boot, followed by special diabetic shoes, and will go on to walk normally again.

Why Do Some Diabetics Develop Charcot Foot?

Many of our diabetic patients wonder what puts some people at risk for developing deformities like Charcot foot. We find there are several factors:

– Genetics: In 2010, scientists from the Charcot Marie Tooth Association scanned patients’ entire genomes and compared the results to other family members. They found that two inherited mutations of the SH3TC2 gene (or 38 other genes) produced Charcot foot symptoms in a couple’s offspring.3http://www.nytimes.com/2010/03/11/health/research/11gene.html?_r=0

– Obesity: More than half of U.S. adults with type 2 diabetes are obese. Excess weight places added pressure on the foot anatomy and also increases the odds of developing nerve damage and non-healing traumatic foot injuries.

– Nerve Damage, Trauma, & Infection: The inability to feel foot pain is a huge problem for many reasons — one of them being that traumas like sprains or stress fractures go undetected and untreated. The more a patient walks on these types of injuries, the more likely bone fracture, joint collapse, and foot deformity become. Pressure sores can lead to bone infections, which also raise the risk of deformity.

– Reduced Bone Mineral Density: Though it is nearly impossible to predict who will or will not get Charcot foot, researchers presume there is a link between reduced bone mineral density and Charcot foot, as the weakened bones are more prone to fracture and infection.4http://care.diabetesjournals.org/content/34/9/2123.full

Diabetic Foot Problems in NYC

Whether you’ve been diagnosed with Charcot foot or are having diabetic foot problems and don’t know where to turn, we invite you to stop in and see the specialists at The Center for Podiatric Care and Sports Medicine. We accept Medicare and all major forms of insurance and work with you to find the most affordable and successful options for your treatment. Contact us to set up an appointment at our Manhattan or Westchester, NY offices.

 

 

Share:

   [ + ]

1. http://onlinelibrary.wiley.com/doi/10.1111/dme.12754/full
2. http://www.loyolamedicine.org/news/charcot-foot-operations-help-diabetes-patients-walk-normally-again-05272015
3. http://www.nytimes.com/2010/03/11/health/research/11gene.html?_r=0
4. http://care.diabetesjournals.org/content/34/9/2123.full

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.