Charcot Foot/Ankle

One thing that is great about the internet - our patients can find out quite a lot of information before we even have a chance to meet them. In most cases this is good - people are interested in conditions that affect their work, hobbies, and even normal daily activities. But “googling” can also scare people to death.

If you search the term “Charcot foot” you’ll find all sorts of horrible images that pop up. True, Charcot deformities can become very involved, but the earlier this condition is recognized and treated, the less chance of complications.

Charcot most commonly affects patients that have diabetes. Not ALL people with diabetes, but some. It is a condition in which the bones/ligaments of the foot begin to breakdown. (Although it can be seen in different areas, I see it most commonly in the mid part of the foot.)

If let untreated, Charcot will become more unstable and the position, shape, and function of the foot will be severely changed. “Rocker bottom foot” is probably a term you came across if you already checked your favorite search engine. This means exactly what it sounds like. The arch collapses and can, eventually, be lower than the ball of the foot and the heel. This means all your pressure is transferred to this area when you walk or stand. When this happens the chances of forming an ulcer over this prominent area of bone become much higher.

I’ve seen many different things that can trigger the beginning of Charcot: sprains, breaks…using a shovel one Saturday in the garden. Sometimes there is a big injury and sometimes it’s just small injury that occurs repeatedly…pushing on that shovel with your right foot for 8 hours in the garden? Yep, that can do it. I’ve seen it.

Remember, the quicker you suspect Charcot and begin treatment, the less chance of severe deformity.

Here are a couple early signs of possible Charcot...

#1: any unusual swelling in your foot or ankle that does not get better after a few days. If you cut back on your activities, and ice the area, and it still swells...you should have it checked.

#2: increased redness or an area that seems warm/hot to the touch. Please don't wait a few days with these symptoms...have it looked at right away.

The early treatment for this condition is complete non-weight bearing and immobilization. Although it is sometimes difficult to be 100% non-weight bearing, the less pressure on the foot/ankle - and the more it is immobilized in a splint, cast, or boot - the less chance of the foot becoming severely deformed.