Few people with diabetes know about the limb-threatening foot condition, or its warning signs
As diabetes rates soar nationwide more patients with a rare diabetic foot complication is on the rise
The condition is called Charcot foot (pronounced SHAR-co). It involves a sudden softening of the foot’s bones. This can trigger an avalanche of problems, including joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation, and even death.

As the foot’s structure collapses, the bottom of the foot can become convex, bulging like the hull of a ship. But diabetes patients frequently won’t feel any pain because they have severe nerve damage in their lower extremities.
Every person with diabetes should know the Charcot foot warning signs: a red, hot, swollen foot or ankle. Several other dangerous conditions, such as deep vein thrombosis and acute infections, share these symptoms. A red, hot, swollen foot or ankle requires emergency medical care.

Charcot cannot be reversed, but its destructive effects can be stopped if the condition is detected early. People with diabetes play a vital role in preventing Charcot foot and its complications. Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. People with diabetes should also inspect both of their feet every day, and get regular check-ups at our center


The following shows a bone model of a Charcot Foot. This is a collapse of the foot in a diabetic patient with neuropathy sometimes resulting is tissue breakdown and forming an ulcer. This is a very serious problem and this could result in a below the knee amputation.

Note how the foot on the left is completely collapsed and that there is a large pressure under the mid foot resulting in tissue breakdown and eventually forming an ulcer. On the right is shown the same patient after corrective surgery to restore the arch with an external fixator.

 

The following are examples of the Diabetic Foot Resulting in a Charcot foot.

Complicated Diabetic Charcot Foot with a large plantar ulcer treated by meticulous surgery with use of an Ilizorov Frame. Specialized training in reconstructive and deformity correction is required prior to attempting to correct such a complicated manifestation of the Diabetic Charcot Foot.

For long term stability, screws were inserted to prevent a breakdown of the severe deformity. Note also the completely healed ulcer. She now wears protective shoes to prevent a recurrence.

Case # 2

This next patient is also a diabetic who has severe instability in ambulating. His foot was a loose bag of bones and was unable to wear proper shoes. The foot was stabilized by mid foot and rear foot fusion and Achilles Tendon Lengthening.

Case # 3: Severe Diabetic foot fracture and limb salvage

 

 

This fracture was stabilized with an Ilizarov external fixation device to realign the fracture. An Achilles tendon lengthening and distraction of the bones were also performed

 

For more stability, internal screws were inserted

The patient still has his foot and is ambulating with diminished discomfort with a brace.