Charcot Foot

WHAT IS CHARCOT FOOT?

Charcot foot is a pattern of bone and joint damage that can lead to foot deformity. Charcot foot begins with peripheral neuropathy, a disease of the nerves in the feet. Because your nerves do not function well, you may not sense pain when you injure your foot. You may break bones or damage joints without knowing it. If you keep walking on your injured foot, fractures can heal unevenly. This causes foot deformity. By catching Charcot early and staying off your feet during healing, you may be able to halt Charcot’s progress.

HOW CHARCOT FOOT DEVELOPS

With Charcot foot, minor fractures can lead to major problems if not treated early.

Acute Charcot foot begins when repeated small fractures are not felt. At first, there may be no visible signs of Charcot. If you keep walking on your foot, fractures become worse. Your foot may feel hot and appear red and swollen.

Fractures begin to heal as Charcot foot progresses. But pressure from your body weight keeps bones from mending smoothly. Continued walking can cause new fractures. Your foot may still be red and swollen.

Chronic Charcot foot is deformity resulting from poor bone healing. Shoes may not fit the deformed foot. Chafing from a poorly fitting shoe can cause ulcers (open sores). Ulcers may become infected. Severe infection may require amputation.

TREATING CHARCOT FOOT

The only way to stop the progress of Charcot foot is to stay off the foot long enough for it to heal. Your doctor will prescribe treatment to help healing.

Non-Weight-Bearing
While fractures are healing, it is crucial that you keep your weight off your foot. This is called non-weight-bearing. Your doctor may ask you not to walk at all. Or, he or she may prescribe a special device. Remember, you often don’t feel pain with Charcot foot.
So even if you feel fine, stay off your foot until your doctor says it’s OK.

Special Devices
Special devices may help you keep weight off your foot. That way, your bones can heal smoothly. A cast lets you walk while keeping weight off your foot. A wheelchair, crutches, walker, or brace may be prescribed alone or with a cast. Other devices may be prescribed to help you keep your foot raised while at home. An elastic bandage wrap or special stocking may also be suggested. This compresses your foot to reduce swelling and aid healing.

Custom Footwear
Once your foot has healed, you may be fitted for custom shoes or inserts (orthoses). Custom footwear is specially made to fit the shape of your foot. This can help prevent ulcers caused by the rubbing from store-bought shoes. If custom footwear cannot stop ulcers from forming, surgery may be needed to correct the deformity.

WORKING WITH YOUR DOCTOR

Your doctor will work with you to diagnose and treat Charcot foot.

Physical Exam
Your doctor will inspect your feet for warmth, swelling, redness, and loss of feeling. He or she will also check for deformity or skin sores.

Testing
The temperature of your feet may be taken. A higher temperature in one foot can be a sign of Charcot in that foot. X-rays can check for done damage. Bone biopsy (a test of a small sample of your bone) can check for infection.

Treatment
Treatment may include staying off your feet and using special devices or footwear. If infection is present, medication may be prescribed. In some cases, surgery may be required.

Following Up
Proper follow-up can help keep Charcot from recurring. Go to all your follow-up visits. Call your doctor if you have any questions or concerns.

PROTECTING YOUR FEET

Protect your feet from further harm. Always wear shoes and socks, even indoors. Test bath water with your elbow before stepping in. Go to your doctor for nail trimming. And check your feet daily for changes.

Check Your Feet Daily
Look at the top and bottom of your feet, your heels, and between your toes. You may need to use a mirror or ask someone to check for you. Call your doctor if you notice wounds or any other changes. This includes increased heat, redness, and swelling.