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Charcot Foot

Charcot foot is a condition in which the foot joints degenerate and eventually collapse, causing severe foot deformity. This problem is usually the result of severe nerve damage in the foot, making it less sensitive to pain and muscle reflexes that control foot movements. With the loss of sensation, the foot is susceptible to repeated injury and fractures leading to the eventual breakdown of the foot arch. People affected by this condition will notice some swelling, redness and warming of the affected foot.

Early diagnosis and treatment can make a big difference in helping people with Charcot foot. The treatment employed is usually a combination of customized footwear, braces for support and rest. On the other hand, the condition will get worse once treatment is delayed and may require surgery or even amputation.

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Causes of Charcot foot

Charcot foot is the degenerative weakening of the foot joints and bones usually as a result of nerve damage. Nerves serve as a communication channel to and from the brain with regards to touch, pain and temperature. It is involved in doing coordinated muscle movements too. With a damaged nerve, the affected part of the body won’t be able to feel pain. The muscles likewise become increasingly weak causing the joint to become unstable and susceptible to repeated injury. Over time, the bone will eventually collapse and cause the sole of the foot or foot arch to bulge out.

Charcot foot is one of the odd effects of diabetes. People with diabetes have abnormally high glucose level in their blood. Too much glucose can damage the wall of small blood vessels in which nerves are fed for nourishment.  Injury to these walls will in turn result in nerve damage. Among the medical conditions that could lead to foot deformity are:

  • Peripheral neuropathy
  • Spinal cord injury
  • Neurosyphilis
  • Pemicious anemia
  • Syringomyelia
  • Hansen’s disease

Incidence of Charcot Foot

Charcot foot is prevalent among diabetics. Statistics show that around 29% of diabetics develop the condition especially those who are in their 50s. Men and women are equally affected by this foot deformity which usually affects one foot, though it could also affect both feet. Those who have chronic hyperglacymia or high blood sugar level and living with diabetes for 15 to 20 years as well as those who have constricted achilles tendon should be wary of developing this condition.

Appearance of Charcot Foot

It is very important to be able to recognize the early manifestations of the condition because the earlier it is detected, the easier the treatment will be. Take note that it does not cause much pain especially during its earliest stages, so it leaves the sufferers completely unaware of the condition. As a result, the affected foot or feet are still constantly being used, hence leading to repeated joint injury.

The following are the hallmark features of Charcot foot:

  • Swelling
  • Redness
  • Increased temperature on the affected region
  • Insensitive foot
  • Strong pulse

If the condition continues to go unnoticed, it would worsen and cause subluxation of bones and joint instability and dislocation. It would only take weeks or months for Charcot foot to develop. In some cases, the symptoms appear following a minor trauma of the foot. The condition may further complicate and cause huge problems once ignored, which include:

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  • Calluses and foot ulcers
  • Bony protrusions which could lead to secondary infection
  • Osteomyelitis
  • Septic arthritis

Severe Charcot foot may require amputation resulting in disability.

Charcot Foot Treatment

Treatment for Charcot foot is invaluable as it helps patients deal with the condition and prevents it from aggravating. Treatment is aimed towards stabilizing the foot joints and bones either through surgical or non-surgical methods.

Non-surgical methods:

  • Immobilization

This is usually recommended so as not to cause too much stress on the weakened joints and bones. Immobilization typically involves limiting physical activities so that the condition will not get worse.

  • Wearing customized footwear and braces

Even if only one foot is affected, both feet will benefit from wearing specially-designed footwear and bracing support.

  • Using crutches or wheelchair

Crutches or wheelchair will not only help the patient in moving around but provides foot protection as well.

Surgical methods:

  • Ostectomy

This is a surgical procedure which involves the removal of any abnormal growth, bone and fragments of cartilage through a cut at the base of the foot.

  • Arthrodesis

This procedure is usually done to realign the middle or hind foot and ankle by removing bone overgrowths and repairing the collapsed foot arch.

Surgery is only reserved for severely deformed foot or feet. After the procedure, customized braces are worn to help the patient move after the surgery and onwards. It may take some time before the patient could go back to his/her normal activities. The doctor will closely monitor the condition to detect possible recurrence.

Prevention of Charcot foot can be greatly aided by maintaining normal blood sugar levels, avoiding foot injury, checking the feet for anything unusual and getting regular checkups.

Charcot foot pictures

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