How to treat Charcot foot?

Charcot’s foot is a complication of diabetes in which the joints become damaged due to the lack of sensation. As any changes in foot posture or alignment are not detected due to the lack of pain sensation, so the foot can become quite deformed if not detected early and treatment started.

The immediate treatment of a Charcot’s foot is non-weightbearing. All weight needs to be got off the foot, preferably using a cast walker or a plaster cast and also the use of crutches. This is crucial. Continued weightbearing is dangerous and will lead to increased deformity. This needs to be continued until the initial inflammatory stages have settled down. This may take at least a few months.

Once this initial non-weightbearing stage has settled down any increase in weightbearing needs to be done slowly and gradually as recurrences are common if too much is done too soon. Foot orthotics, preferably custom made, and special footwear should be used as they will help to keep the foot in a stable position.

Invariably reconstructive surgery is needed as the deformity progresses and the joints are unstable. this will often involve the fusion of joints in a more stable position.

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