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Surgical Management of Diabetic Charcot Foot

What is a Charcot Foot?
Charcot foot is destructive and non-infective arthritis that affects nearly 2.5 percent of individuals with diabetes. On average, people around 40 years of age develop Charcot foot. It is possible to develop this condition in the feet and ankles. This type of arthritis has a history of developing suddenly without the person experiencing any pain. The feet and/or ankles can spontaneously fracture and break in a short period of time.

Developing a diabetic Charcot foot is a severe foot deformity and wearing normal shoes can be difficult. The more the problem progresses the foot will change aesthetically as well; it will begin to look more like “rocker bottom.” Pressure develops on the bottom of the foot as the arch collapses leading to sores and ulcerations. Sometimes, patients may not be able to walk without the use of a brace because the ankle stability is depleting. The doctors at Metroplex Foot and Ankle keep up with the latest technology and trends to treat your conditions and have many options to help you that do not require surgery.

However, there are cases where the deformities are too severe and may need surgery. These chronic cases include: 1) deformities where the braces will not correct the problem; 2) deformities that cause increased plantar pressure and ulceration; 3) deformities when non-operative therapy failed; and 4) ulcers that continue to reappear.

Surgical Management of Diabetic Charcot Foot
Before having your foot operated on, there are many factors that need to be addressed to ensure that you are getting the right surgery performed. These factors include determining the exact location of the deformity; what stage the Charcot is in; are ulcers are present; stability of the deformity; and over all health of the patient.

What are the Types of Surgery to Expect?
1) Ostectomy – This procedure involves removing part of the bone from the bottom of the foot. By removing the portion of the bone that’s causing increased pressure, this will allow the current ulcer to heal and prevent future ulcers. Normally this procedure is an outpatient surgery with a recovery time of three to four weeks with the use of a cast.

2) Midfoot Realignment Arthrodesis – If the ostectomy will not fix your Charcot deformity, then this might by the next step. When there is significant instability in the middle part of the foot and the foot has collapsed and a bony prominence is present, then surgery needs to happen quickly. Screws and plates may need to be inserted into the foot to keep it in the proper place. Healing time can be lengthy but necessary. Expect to be in a non-weight bearing cast for about three months and then move into a weight bearing cast for an additional one to two months.

3) Hindfoot and Ankle Realignment Arthrodesis – This will take place when the patient can no longer walk. When this happens, the patients are pretty much non-ambulatory and amputation could be the only alternative. Maintaining functionality of the limb is the main goal of this surgery with the help from the use of braces. Various types of internal and external devises may be used to help correct the position of the foot. Healing time is very lengthy. Expect to be in a non-weight bearing cast then an additional two to three months of walking in a protective rocker bottom brace. After healing, the patient will need to have a custom brace that they may need to use for the remainder of their lifetime.

If you are having trouble walking and ready to be out of pain, contact us to get started on your journey to recovery.

Metroplex Foot and Ankle is a progressive group of physicians and surgeons who are committed to helping our patients to achieve their full wellness potential. Contact our Dallas Podiatrist, Garland Podiatrist, or Richardson Podiatrist offices to schedule an appointment today.

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