The Center for Podiatric Care and Sports Medicine

Foot Problems: What Is Charcot Foot?

Posted by on Tuesday, July 9th, 2013

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Charcot foot occurs in roughly 1 – 2.5% of people with diabetes, primarily those with Type I diabetes who are in their fifth or sixth decade of life. It is a very serious condition that can lead to deformity, disability, and even amputation. Due to these dire consequences, it is important that you see a podiatrist immediately if you suspect you’ve encountered some signs and symptoms of this disease.

What Is Charcot Foot?

“Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy),” says the American College of Foot and Ankle Surgeons. As the foot disease progresses, the bones weaken and fracture, the joints collapse, and the foot begins to take on a deformed shape.

The symptoms of Charcot foot may include:

  • Warmth
  • Redness
  • Swelling
  • Pain

Patients often do not notice foot problems until the condition has become severe. The acute Charcot foot is often painless, but mimics the symptoms of cellulitis or deep venous thrombosis. Sometimes people believe they have merely sprained an ankle. To diagnose, a foot surgeon will take an x-ray and conduct a physical examination of the feet.

What Causes Charcot Foot?

The excess blood sugar in the body of a diabetic creates an acidity in the body, which corrodes the blood vessel walls. The lack of blood due to poor circulation leads to nerve tissue death. Without nutrition, the bones and joints also begin to fail. Neuropathy is the decreased ability to feel temperature, pain or trauma — so individuals do not even feel their bones breaking and joints degrading. For these reasons, diabetics who have had neuropathy for more than a decade — and who have a tight Achilles tendon — often develop the condition.

Charcot Foot Treatment

Non-surgical treatment includes immobilization to prevent further collapse of the bones and joints. During this time, a cast, boot or brace is required and you may need to use a wheelchair or crutches to get around. It can take the bones anywhere from six to 24 months to fully mend. Once the bones heal, custom shoes and braces are often needed to prevent recurrence of Charcot foot, as well as ulceration.

In many cases, the condition has progressed to a level that requires surgery.  An exostectomy may be done to remove the bony portions of the mid-foot that have grown along the sole to compensate for tendon breakdown (in cases of “rocker bottom foot”). A more complex surgery called arthodesis may be done to correct midfoot and hindfoot deformities that cannot be corrected with braces. A newer surgical technique uses a circular external fixator, a rigid stainless steel frame, to secure the bones following surgery — which has been said to help 90% of patients walk normally again.

Here at our NYC Center for Podiatric Care and Sports Medicine, we use the latest technology to get you back on your feet again.

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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.