Charcot Foot: Walking on Bone Fractures
For those with diabetes, foot care is of the upmost importance. Nerve damage and poor circulation are both associated with the disease and make diabetic feet especially vulnerable to complications. One such problem that can arise is called Charcot foot—a serious and damaging condition that can lead to deformity and possible amputation.
Diabetes can cause a loss of sensation in your feet, so even the slightest problem can go unnoticed. Poor circulation is also associated with diabetes and can weaken bones to the point of disintegration. These two combined are a dangerous pairing, since a fractured bone can occur without ever being felt. Continuing to walk on it can cause further damage, and if left untreated, this can deform the shape of your foot bringing on an onslaught of serious problems.
Set your Sights on the Symptoms
Early detection is key to avoid irreparable damage. The main sign of Charcot foot, also known as Charcot arthropathy, is severe swelling. Redness in the area is also an indicator. These symptoms mimic a bone infection, but if the skin is intact and there is no visible ulcer, then a bone infection is unlikely. X-rays can help confirm a diagnosis.
Treatment is Two-Fold
Treatment for this condition involves not only healing the bone, but also preventing any further joint destruction or deformity. Typically, this is achieved by placing a cast on the foot to protect it, reduce inflammation, and enforce immobility. This will also aide in keeping weight off of the foot—an essential component in the healing process. Once swelling has decreased and the bone has begun to fuse back together, a customized walking boot or shoe may be recommended to reduce the risk of ulcers forming around pressure areas.
If these treatments are not effective, or bones are dislocated and unstable, surgical procedures may be the only course of action to correct the problem.
Mild deformities involving tightness in the heel can benefit from surgery that lengthens the Achilles tendon. This decreases the pressure placed on the mid and forefoot, thus reducing the chance of an ulcer developing there.
More severe deformities, like those with boney prominences, will require surgery that entails shaving the bone and/or removing it completely. If bones are unstable, however, it will be necessary to reposition and fuse them together.
For complex bone damage, operations may need to involve hardware such as screws and metal plates. This procedure holds a higher risk of infection, so a strict adherence to the doctor’s instructions is vital.
The sooner Charcot foot is treated, the better the final outcome will be. Early diagnosis, immediate immobilization, and a commitment to preventative foot care can minimize the potential for devastating complications. If you have any questions or wish to find out more, call Dr. Harvey Danciger at (760) 568-0108. You can also visit us online or at our Palm Desert, CA, office. Remember, check your feet every day and seek help right away if any problems are discovered.
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