Treating Charcot Foot: Surgery or Not?

Treating Charcot Foot
If you have peripheral neuropathy, there’s a chance you could also develop Charcot foot. This condition weakens the bones of your foot, as well as your joints and soft tissues, while causing painful sores or changing the shape of your foot.

As many as 2.5 percent of patients with diabetes can develop Charcot foot, and it can recur in as many as five percent of cases.

Fortunately, your doctor can help you in treating Charcot foot, largely reversing the damage it causes. Depending upon the severity of your case, you could receive medical or surgical therapy. Any treatment option you receive will have similar goals: take weight off the injured foot, address bone disease, and prevent future foot fractures.

Charcot Foot Diagnosis 

Imaging scans can help your doctor determine what treatment type you need. X-rays offer detailed pictures of dense structures, such as bones. MRI and ultrasound provide good imaging of foot and ankle soft tissues, potentially identifying any bone infections. Bone scans are nuclear tests that can also identify bone infections. A specific test — an indium scan — tags your white blood cells and follows them to the infection site.

Treating Charcot Foot

Whether your doctor recommends surgical or non-surgical treatment, you will get the best long-term results if you closely follow your physician’s instructions. Most specifically, wait until he or she tells you it’s safe to put weight on your foot again.

Also, be sure to check your feet daily for any problems, including scrapes or lingering sores. If any exist, immediately contact your doctor. The sooner you get treatment, the more likely you are to have a good outcome.

Non-surgical treatment: Offloading — keeping your weight off your affected foot — is the most important part of treating Charcot foot without surgery. For anywhere from 8-to-12 weeks, you’ll wear a protective walking boot or cast. The protective footwear should stay in place until any redness, swelling, or heat disappears. The Charcot Restraint Orthotic Walker (CROW) is a commonly used device.

The second step is prescription orthotic shoes. These shoes must fit appropriately, providing enough room for your toes and enough cushioning for the heel, arch, and ball of your foot. The right shoes won’t have any pressure points, reducing the risk of injury or ulcers.

You’ll also need to change your activities to avoid repetitive trauma to both feet.

Surgical treatment: Surgery is recommended for individuals with severe ankle and foot deformities that could make using a brace or other orthotics difficult. These patients are also at a higher risk for developing foot ulcers.

Surgery could involve re-aligning the bones of your foot or removing some that could cause ulcers. According to recent research, most patients with diabetes are able to resume normal walking after surgery.

Because infection risk is high post-surgery, you’ll be instructed not to put your full weight on your foot until your doctor gives you the green light. You’ll also need to commit to wearing protective footwear for life.

Remember, it is possible for Charcot foot to return, so stay vigilant with your foot hygiene.

For more information on treating Charcot foot, contact the Amputation Prevention Centers of America.

After Foot Amputation — What’s Next?

Foot Amputation

A foot amputation can be a scary procedure to face. But, completing a successful operation is your surgeon’s job. Your work begins after the procedure.

Knowing what to expect after a foot amputation can help you toward a speedy, healthy recovery. Your hospital staff will give you medications to alleviate pain and fight infection, but you need to know more. Here’s what you can anticipate:

In the hospital after your foot amputation

After moving to your hospital room post-recovery, nurses will change your bandages and will teach you to do so, as well. You will also start the early stages of physical therapy with stretching and some gentle exercises.

Perhaps, most importantly, you will receive information and guidance about your prosthetic foot (if you’re choosing to get one).

At home 

If your healing progresses well in the hospital, you’ll likely go home after a few days. Once there, be sure you follow your surgeon’s instructions about bathing, activity level, and physical therapy to ensure your best recovery.

Physical therapy starts with gentle stretching and will progress to exercises that will improve your muscle control, enable you to resume daily activities, and help you regain independence. It will also include practice with your prosthetic or assistive devices.

Only take pain medications prescribed by your doctor. Even taking an aspirin can increase your bleeding risk.

If you experience swelling, redness, bleeding, worsening pain, numbness, or tingling, contact your surgeon immediately. These symptoms could be normal, but they could also indicate a need for immediate attention.

Inpatient rehabilitation

If you have additional health problems or you’re not recovering your mobility quickly, your doctor might recommend an inpatient rehabilitation facility.

Healthcare providers will focus on wound healing, rebuilding your strength, preparing your leg for the prosthetic, and improving your mobility. They will also teach you how to care for your new prosthetic.

Ongoing rehabilitation

Prosthetics: If you opt for an artificial foot, you’ll need to be fitted properly, learn how to care for it, and how to walk.

It’s possible your leg will still be swollen when you get fitted for your first prosthetic. If so, you’ll receive a temporary one, getting the permanent one within six to 12 months.

Mental health: Losing a limb can be emotionally traumatic. You can develop feelings of depression, anxiety, grief, denial, and suicide. If you feel any of these emotions, contact your doctor immediately. Your care team has support resources.

Complications

Even successful surgeries carry risks. Blood clots and infections can occur with amputations. If left untreated, these problems can cause nerve pain, phantom pain (pain felt in a removed limb), and bone spurs at the end of your leg.

Contact your surgeon if you experience any complications. While it might be possible to correct the problem with medication, there’s a chance you could need additional surgery.

Ultimately, going into your amputation surgery with a clear understanding of what your next steps will be could put you on a path to a quicker, healthier recovery. If you know what to expect, you can be better prepared.

If you have any questions about a foot amputation, contact the Amputation Prevention Centers of America.