Charcot Foot
Prevention and Treatment of Charcot Foot
Proper blood glucose control is essential for preventing Charcot foot in people with diabetes, since high levels of blood glucose damage the nerves and can lead to neuropathy and loss of protective sensation. Daily self-examination of the feet is essential when sensation has been lost. Look for swelling and redness, and feel for skin temperature elevation; if present, consult your physician immediately. If he or she suspects Charcot foot, an imaging test such as an X-ray, CT or MRI scan will most likely be done to confirm any damage to bones, tendons or ligaments.
Treatments for Charcot foot focus on healing whatever damage has taken place, as well as reducing the risk of further damage. These can be non-surgical, or in cases of severe damage, surgery may be required. Common treatments include:
- A cast, boot or healing footwear to immobilize, support and protect the foot.
- An assistive device that keeps weight off the foot – wheelchair, crutches, etc.
- Modifying activity to avoid trauma to the Charcot foot and reduce the risk of the condition developing in the other foot.
Once the healing process has started, special accommodative footwear may be used to help protect and cushion the feet and prevent ulceration in areas where abnormal pressure points have developed.
As for many conditions, surgery is an option of last resort. It may be appropriate if the foot becomes so deformed that it interferes with a person’s ability to walk and do other activities of daily living. The type of surgery depends on the nature and the location of the damage in the foot. Procedures include:
- Lengthening of the Achilles tendon to help reduce pressure in the forefoot and midfoot.
- “Shaving” bony prominences so that they do not protrude through tissue and skin or contribute to high pressure areas that can lead to the development of calluses and ulcers.
- Fusion and repositioning of bones.
- Stabilizing bone structures with screws and plates.