Charcot Foot Care for Diabetic Patients

What You Need To Know

Understanding Charcot foot is the first step toward protecting your mobility.

Understanding Charcot Foot

Charcot foot is a serious complication that impacts the bones, joints, and soft tissues of the foot and/or ankle. It typically results from nerve damage in the feet due to diabetes or nerve injuries. Those with diabetes mellitus are particularly prone to the condition. The bones become weak and can break, and the joints in the foot or ankle can dislocate. If not caught early, the joints can collapse and the foot becomes deformed. This can cause pressure sores, which may lead to infection and amputation.

When the midfoot is impacted, the arch collapses and the bottom of the foot rounds. This is called a rocker-bottom foot deformity. Depending on the location of the fracture, the toes can also begin to curve, or the ankle can become deformed and unstable. Oftentimes, Charcot foot isn’t associated with any pain, so it’s imperative that you stay on top of your foot health.

Symptoms include a red appearance of the foot or ankle, swelling, increased warmth compared to the other foot, a foot that feels warm to the touch, and soreness. Because the patient may not feel pain, these visual and temperature changes are often the first warning signs.

Your board-certified podiatrist will examine your foot and ankle, ask about your symptoms, and may take the temperature of your feet. X-rays and other imaging may be used, and in some cases a bone biopsy may be ordered to check for infection. If you notice any symptoms, contact your podiatrist immediately for evaluation.

Treatment, Risk Factors, and Prevention

Charcot foot is most commonly the result of peripheral neuropathy, a disease of the nerves. Because the patient cannot feel pain or other sensations, an injury can be made worse by continued walking. Repeated small fractures that aren’t felt or don’t heal correctly can worsen and lead to Charcot foot. Blood vessel damage can also change blood flow to the feet, leading to bone loss and an increased risk of fractures. Diabetics are most at risk, especially those who have had diabetes for several years. Other risk factors include smoking, regular alcohol consumption, high blood pressure, high cholesterol, kidney disease, and being overweight.

Decreasing pressure on your feet is one of the most important ways to heal Charcot foot. Non-surgical treatment includes immobilization with a cast, boot, or brace, custom orthotics, and activity reduction. You may need a knee scooter or crutches during recovery. Custom orthotics and bracing can help the bones heal and prevent recurrence.

Surgery may be necessary if Charcot foot has caused a severe deformity or if an infection has spread. A board-certified surgeon will repair the damage and stabilize your foot. Your physician may consider limb salvage surgery to prevent amputation, providing a stable foot that will not develop further ulcerations.

To help prevent Charcot foot, manage your blood sugar, wear shoes and socks even when indoors, and stop any activity causing foot or ankle pain. See your podiatrist at least once per year if you have neuropathy or diabetes, and call our office right away if you notice any warning signs.