• Charcot foot develops secondary to multiple factors.
    1. Diabetic neuropathy causes failure to sense pain and causes failure to control small blood vessels in the foot.
    2. Diabetes causes tendons, ligaments and connective tissues that hold bones and joints together to weaken.
    3. Osteoporosis or weakening of bone structure can predispose to fracture.
    4. Mechanical abnormalities especially flat-foot deformity and contracture or tightness of the Achilles tendon can predispose to fracture.
  • Presentation
    1. Frequently Charcot foot presents as mild chronic swelling with or without pain that affects the foot locally.
    2. The diagnosis is frequently missed in these early stages. If this happens it is bad.
  • Treatment
    1. Protection, bracing, casting, and immobilization is used in the early stages prior to fracture and dislocation of bone to allow injured tissues to heal.
    2. Following fracture and dislocation of bones bracing is not very helpful. Surgical repair of bone and soft tissue with fusion of joints becomes necessary. Months of casting, immobilization and recuperation become necessary.
  • Failure to treat Charcot collapsed foot frequently results in:
    1. Ulceration of the foot
    2. Multiple surgical procedures including amputation of the limb
    3. Permanent disability.

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