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Charcot Arthropathy

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Charcot arthropathy or Charcot foot as it is commonly known is a disease causing destruction of the bones and joints of the foot leading to severe foot deformities.

Charcot Foot

This condition is common in diabetics with peripheral neuropathy or other conditions that may cause neuropathy. You can characterize this disease by microfractures and joint dislocations of the foot and ankle which lead to foot deformities.

Most common deformity is a rocker bottom foot which results from the collapse of the midfoot. When patients continue weight bearing on such a foot, that results in skin ulceration of the weight bearing surface which then turns into a bone infection called osteomyelitis. Many times our initial contact with the patient is when the deformity has already progressed to an ulcer with bone involvement. Treatment is challenging and can lead to amputations. For these reasons it is paramount that this condition is properly diagnosed and managed at an early stage.
Early symptoms include a red, hot swollen foot with or without pain. Radiographic images are taken in the office to aid with diagnosis but often no changes are visible on X-rays and diagnosis is based on a high index of suspicion. Treatment includes immediate Non weight bearing in cast or CAM boot. Once the acute condition is stabilized I usually place my patients in a Charcot Restraint Orthotic Walker (CROW) to offload pressure areas and prevent ulcerations.
Surgical correction is always considered which can range from multiple osteotomies of the bone to correct the deformity with internal fixation with plates and screws. Oftentimes I apply an external fixator on the affected limb for a “superconstruct”. Treatment and compliance can be challenging at times but this is a life altering condition and if not diagnosed early and managed properly can have devastating long term consequences.
Acute Charcot Arthropathy

Acute Charcot with total collapse

post op charcot foot

Post op X-rays showing restored medial column

Charcot Arthropathy info

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For our patient’s convenience, we offer foot and ankle treatments for all kinds of conditions such as Charcot foot in Adrian, MI, Charcot foot in Ann Arbor, MI, and Charcot foot in Jackson, MI. We have our own digital x-ray, MRI, Cat-scan, and ultrasound equipment at many of our podiatry clinics. Our on-site podiatric physical therapy clinics allow for constant communication between the physicians and physical therapists, ensuring the most effective therapy and successful recovery for our patients.

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