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Charcot Foot- Diabetes

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I work as an Lpn, I have diabetes. My husband has diabetes, neuropathy and has been battling Charcot for over a year.

Charcot, diabetes and neuropathy

What is Charcot?

Charcot is a rare progressive, degenerative disease that can affect people with neuropathy especially those with diabetes. The disease effects the bones of the foot and also the joints and soft tissues of the foot and ankle. The bones become weak enough to fracture and if one continues walking, the foot will change shape. The bone may push through the bottom of the foot. The joints and soft tissue then dislocate.

A person that suffers from neuropathy that is bad, their sense of balance may be affected. Due to not being able to feel anything, the person keeps walking on the foot and it causes them to walk off-balance and also in an unnatural way, which can cause the joints in the foot to collapse. This can cause a visible deformation, seen as arch of the foot flattening.

What Causes Charcot Foot?

Charcot foot affects people who can’t feel anything in their feet because of nerve damage which is called neuropathy. It is also a common problem for people with diabetes. Diabetes is one of the most common cause of neuropathy. Other causes of neuropathy : spinal cord injury, infection, alcohol and drug abuse, Syphilis and HIV. Charcot is a progressive disease that can get worse over time.

Symptoms of Charcot

Sometimes a minor trauma such as a sore on the foot, may cause symptoms to appear. Symptoms may:

  • Redness over the area of the foit.
  • Swelling becomes apparent where the disease is visible.
  • Pain or soreness
  • Warm to touch. The affected foot feels warmer to touch than the other one.
  • Instability in the joints
  • Loss of sensation in the foot
  • Discoloration of the foot
  • Deformity of the foot

Early diagnosis and detection can generally lessen the probability of complications which can be destructive. If Charcot is not diagnosed and managed properly it can lead to amputation of the affected foot.

Treatment

  • Non-Surgical Treatment -The first step in nonsurgical treatment for the early stages of Charcot foot is to take all weight off the foot—this is called offloading. A person can use crutches,knee walker or a wheelchair to get around. So it is imperative not to walk on the foot that is affected as least until the the doctor finds it is safe. At times during this time the infected person usually is fitted with a removable boot or brace, fitted with a cast or may have to use a wheelchair or crutches. It may take these bones months to heal but this is different in each individual.
  • Custom made shoes and braces-The individual may need a fitted shoe with special inserts after the bones have healed to be able to return to a normal life.
  • Activity modification - Modification in activity may be needed to prevent further damage. An individual with chariot in one foot is likely to develop it in the other foot.

Surgery - reconstruction is a limb salvage procedure. This procedure realigns and stabilizes the foot. A surgeon can use different techniques such as: Internal Fixation, External Fixation, or both, to treat the Charcot foot. The goal of surgery is to remove bony protrusions and correct the rocker-bottom associated with Charcot Foot.

It is important to remember that there is no surgery or treatment option that will cure Charcot Foot. No matter how successful surgery is a person will still have Charcot Foot and can continue to experience fractures.

You should always consider your risk factors and ultimate goals for living with Charcot Foot. Factors to consider are:

  • If you are diabetic, keep your blood sugar under control.
  • Check your feet regularly for any changes.
  • Keep all follow up appointments.





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