Charcot Foot and Ankle - Dr. Jeffrey E McAlister
 

Charcot Foot and Ankle

Charcot Foot and Ankle

Charcot of the foot and ankle, also called Charcot Neuroarthropathy, is a condition that causes weakening of the bones, which can occur in people with significant nerve damage (neuropathy). The condition is especially prevalent in people who suffer from diabetes or other potentially nerve damaging conditions. The bones are weakened enough to fracture. With continued walking, the foot eventually changes shape. As this occurs, the foot and ankle have a high risk for skin breakdown or ulceration, which can lead to infections. Charcot of the foot and ankle is a very serious condition as it may lead to severe deformity, disability, or even worse, amputation. Having Charcot foot in one limb puts a person at increased risk of developing it in the other.

Symptoms, Causes, and Treatment for Charcot Foot

Symptoms of Charcot Foot

Due to its seriousness, it is very important that patients take preventative measures and seek immediate help if they experience any of the following symptoms. When Charcot foot begins, your foot may be:

  • Warm to the touch (the affected foot may feel warmer than the other)
  • Red
  • Swollen
  • Pain or soreness in the affected foot

Causes of Charcot Foot

Charcot foot develops because of neuropathy, which decreases a person’s ability to feel sensations of pain, temperature, or trauma. Due to having a diminished sensation, a person may continue to walk, thus making the injury worse. Those who have suffered from neuropathy for an extended period are at risk for developing Charcot foot. Also, those who have a shortened Achilles tendon are even more likely to develop Charcot foot.

Treatment for Charcot Foot

Non-Surgical Treatment Options for Charcot Foot

  • Immobilization – A patient may need to wear a cast, removable boot, or brace, in addition to using a wheelchair or crutches. This allows the bones in the foot to heal, which is important because the foot and ankle are extremely fragile, making preventing further collapsing of the bone imperative.
  • Custom shoes and bracing – Custom shoe inserts may be needed after the bones heal to prevent Charcot foot from reoccurring. In more severe cases in which deformity occurred, custom braces may be needed to resume normal function.
  • Activity modification – A patient may need to reduce their activity level to prevent Charcot foot and trauma from reoccurring as well.

Surgical Treatment Option for Charcot Foot

Surgery may be necessary to correct serious deformity that resulted from the condition.

Exostectomy – If a bony prominence is present (with or without ulcerations), removal of the prominence may be a treatment option.

Reconstruction – For situations where the foot is unbraceable or in the case of chronic, non-healing ulcers, reconstruction may be necessary. It is of the utmost importance that this procedure be performed by a surgeon specifically trained in Charcot Reconstruction with training in external fixation.

Amputation – Used in only the most severe cases and only when the foot is unsalvageable due to abscesses, infection or extensive bone loss.

Again, Charcot foot is a very serious condition. Dr. McAlister has specific training in caring for this condition. He is fellowship-trained as a foot and ankle surgeon with experience both treating Charcot foot conservatively and in surgery for reconstruction or amputation, when necessary. If you have or suspect you have Charcot foot, it’s important to get care early and begin a treatment plan.

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