What is the Charcot foot?

Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking, the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

Charcot foot is a serious condition that can lead to severe deformity and reduced walking ability.

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How is it commonly caused?

Charcot foot affects people who can’t feel anything in their feet and ankles because of nerve damage. That’s a common problem for people with diabetes.

 

Symptoms

The symptoms of Charcot foot may include:

• • Warmth to the touch (the affected foot feels warmer than the other

  • Redness in the foot

  • Swelling in the area

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Complications of Charcot Foot

As your bones get weaker, they can break and move out of place. When that happens:Your foot may lose its shape. The arch in the middle of your foot may drop until the bones are lower than your heel or toes. Doctors sometimes call this “rocker bottom. Bones may press against your shoes. This can cause open sores on your skin that can get infected. Poor blood flow, which is a common side effect of diabetes, may make it hard for infections to heal. If that goes on too long, you may need to have your foot removed.

Nonsurgical Treatment

• Immobilization. Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the weakened bones can repair themselves. Complete nonweightbearing is necessary to keep the foot from further collapsing. During this period, the patient may be fitted with a cast, removable boot or brace and may be required to use crutches or a wheelchair.

• Custom shoes and bracing. Shoes with special inserts will be needed to enable the patient to return to daily activities—as well as help prevent recurrence of Charcot foot, development of ulcers and possibly amputation. In cases with significant deformity, bracing is also required.

• Activity modification. A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both feet.