Charcot foot is a serious condition affecting the bones, joints, and soft tissues of the foot and ankle. It happens when weakened bones fracture, and joints dislocate, often due to nerve damage that prevents feeling in the feet. As the condition worsens, the foot may become deformed, developing a collapsed arch or dislocated ankle. Early diagnosis and expert care are crucial to prevent severe complications like ulcers, infections, and even amputation.
What is Charcot foot?
Causes and Risk Factors
Charcot foot develops from nerve damage (peripheral neuropathy) that reduces sensation in the feet, making it hard for patients to feel pain or notice injuries. This condition is most often linked to diabetes, but any cause of nerve damage can lead to Charcot.
Repeated trauma, like walking on a fractured foot without realizing it, worsens the damage. Without prompt treatment, it can quickly cause severe deformities. Early diagnosis and care can lower the risks and help restore function.
Symptoms
The early signs of Charcot foot can be subtle but should never be ignored. Symptoms include:
- Redness of foot
- Local swelling
- Warmth to touch
- Pain or soreness
- Deformity of foot
- Unstable ankle joint
Diagnosis
Early diagnosis of Charcot is imperative to preventing complications and ensuring good outcomes. A proper diagnosis of Charcot foot requires a thorough clinical evaluation by a foot and ankle specialist. Additional tests such as blood work, or imaging including X-rays, MRI, and /or CT scans may be ordered.
Charcot Foot Treatment
Conservative Management Immobilization and stabilization are required. This can be done through the use of a removable medical boot or cast to immobilize the foot while the bones heal. In some cases, non-weight bearing is required to prevent further collapse. Patients can use crutches, knee scooters, knee pegs, or wheelchairs during this period. Custom shoes and braces can be used for long term management. Activity modifications can be performed to avoid high risk repeated trauma.
When is Surgery Required? When the deformity is severe or complications such as ulcers and instability develop, surgical intervention may be necessary. The goals of surgery are to realign the foot, allow the bones to heal in proper alignment, and reduce the risk of future complications.
Minor Procedures: In some cases, minimally invasive techniques are used to improve the foot alignment while the bone heals
Charcot Reconstruction: Procedures vary and can include joint fusion to complex reconstructions of the foot structure. Application of external fixation can be used to further stabilize the foot and potentially allow immediate walking following the surgery. Internal fixation is also used including screws, plates, and intramedullary beaming / nails to hold the correction.
Charcot Reconstruction: Procedures vary and can include ankle fusion as well as fusion of other joints in the foot to restore stability and alignment. Ankle fusion, midfoot or hindfoot fusions help reduce pain, prevent further deformity, and create a more stable foundation for walking. Internal fixation is also used, including screws, plates, and intramedullary beaming/nails, to hold the correction achieved during ankle fusion or other joint fusion procedures. Application of external fixation can be used to further stabilize the foot and potentially allow immediate walking following the surgery.
Why Choose Us for Charcot Foot Care
Foot Surgery San Francisco offers comprehensive care, from conservative management to advanced reconstructive surgery, tailored to each patient’s unique needs. Charcot foot is a serious condition that requires prompt and expert care. If you notice signs of a red, hot, swollen foot or experience foot deformity, schedule an appointment today for a comprehensive evaluation and personalized treatment plan.
Articles
In addition to Dr. Nicole Cates’ surgical residency training at MedStar Georgetown University Hospital, she completed additional surgical training specializing in Charcot reconstruction and complex deformity correction fellowship at the University of Maryland Department of Orthopaedics. Dr. Cates has published extensively on Charcot foot in peer-reviewed journals:
