Charcot foot (also called Neuropathic Osteoarthropathy) is a severe condition that develops in individuals with peripheral neuropathy. This is a process of inflammation of the soft tissues, bones, joints of the foot and ankle. Without detection and proper management Charcot Foot can lead to surgery, deformity and worse outcomes.
What Is Charcot Foot?
Complete or close numbness in one or both feet or ankles can cause Charcot foot. The foot bones grow weak due to this illness, making them vulnerable to fractures and dislocations. Pain from fractures or traumas can go unnoticed because the foot is numb, resulting in extra walking and standing injuries. Sometimes, the joints might dislocate or even collapse as the bones decay, affecting the foot’s shape. The resulting form is called rocker-bottom foot as the arch grows down and out, resembling a rocker.
Not only this, but the Charcot foot can cause incurable painful ulcers. If not treated on time, studies have shown that this can result in permanent deformity leading to disability and even death.
Causes Of Charcot Foot
There are no sure ways to specify the causes of this condition. But instead, a series of events might prove to be the significant risk factor that produces a Charcot Foot. Most commonly, undetected sprains or injuries are a regular occurrence because the person suffering from peripheral neuropathy cannot sense pain so the injury may go undiagnosed.
In diabetic patients, Charcot foot has also been seen as a complication after organ transplantation. This happens due to drugs used to prevent organ rejection which leads to intense side effects like bone loss and fractures. Although Charcot foot is often closely linked with diabetes as the cause, peripheral neuropathy is connected to various disorders. These are some of them:
- Drug abuse
- Hansen’s disease
- Infection, trauma, or damage to peripheral nerves
- Parkinson’s disease
- Other inflammatory conditions (such as sarcoidosis or psoriasis)
Charcot Foot Diagnosis
Most commonly, X-rays produce images of the foot’s bones and joints. Yet, it is hard to identify the signs at the early stages. In that case, Charcot Foot is diagnosed by observing the condition’s symptoms. These may include red and hot swollen feet with increased skin temperature.
While in the later stages, X-rays and MRIs are helpful. These are followed by a series of physical exams that might indicate signs of neuropathy. Doctors also examine the muscle tone and strength in the leg and foot and test your tendon reflexes.
How Can Charcot Foot Be Treated?
Once the condition is diagnosed, the patient may undergo two types of remedies depending on the severity of the disease—non-Surgical and Surgical Treatments.
In the early stages of the Charcot foot, treatment focuses on minimizing inflammation and heat in the affected area by stabilizing the foot. To avoid further harm to the foot, removing any weight or pressure on it is critical, generally called Off-loading. Various other therapies include:
- Wearing custom orthotics insoles and shoes they help reduce pressure and maintain proper alignment of the foot.
- Sometimes a contact cast is fitted to the leg or foot.
- Using orthotic braces
- Using a wheelchair for offloading
The non-surgical treatment may be needed for a few months. You should see a doctor regularly to have your development monitored during this time. If only one foot is affected, the symptoms of the other foot will be observed throughout this period.
In extreme conditions like a persistent sore or ulcer, the doctor may recommend you to undergo surgical treatments. Surgery may be necessary if the abnormality makes bracing and orthotics hard to use. The patient will have to avoid putting total weight on the Charcot foot for a long time after the treatment. A few surgical options are:
- Ankle fusion: using bolts and screws to lock ankle joint motion
- Exostectomy: Removing plantar prominences
- Reconstructive Osteotomy: Bone realignment surgery
- Amputation and prosthetic fitting: Fitting prosthetic device after removing a foot.
It is crucial to remember that both patients and doctors use pain to determine the severity of a condition. They may sometimes overlook this dangerous condition due to minor discomfort or the absence of pain. Everyone with Charcot foot must wear protective footwear and take special care of their feet. Prevention of future troubles begins with educating the patient and family members on proper foot care and noticing warning signals in advance.