Charcot foot is a serious, limb-threatening complication of diabetes in which the bones of the foot or ankle degenerate and become deformed, leading, if incorrectly treated, to disability and amputation.
The condition arises from a combination of factors associated with diabetes. Diabetics with neuropathy (loss of sensation) have less feeling in their feet and may also have reduced muscle control and tissue damage. This affects their sense of balance and their walking gait and increases their risk of knocks, sprains and cuts, particularly to the soles of their feet. Diabetic neuropathy also reduces their ability to perceive pain following a minor injury to their feet, which means they can remain unaware of an easily treatable injury, such as a blister, until it becomes infected and ulcerated. As they continue to walk and put pressure on the affected foot , this increases the damage to the bones and tissues and their risk of serious disability.
Charcot foot develops over time but is often triggered by a minor injury, such as a sprain or twisted ankle, which remains untreated because it goes unnoticed.
Who is at risk of Charcot foot and resulting disability?
Diabetics are at risk of developing Charcot foot.
Their risk is increased by:
- poorly controlled diabetes
- reduced sensation (neuropathy) in the feet
- impaired vision reducing the ability to carry out daily visual foot checks
- existing ulceration
How can I reduce my risk of developing Charcot foot?
The key to reducing the risk of Charcot foot and other serious diabetic complications is good management of the diabetes, including good foot care, regular check-ups and prompt medical treatment of any injury (however minor) which could lead to more serious infection.
If an individual with diabetes has reduced sensation in their feet they must carry out daily visual foot checks to ensure that they seek help as soon as possible after a minor injury occurs. If they have impaired eyesight they should ask someone else to check their feet for them.
They should see their GP immediately if their feet have:
- Minor cuts
- Redness, warmth and swelling
- Discharge or fluid oozing from the foot into socks or tights
- Or if they feel generally unwell
Treatment from the GP might include:
- Advice to rest the foot
- A review of their diabetic medication and management
- Referral to a foot-care specialist
- A personal care plan
What are the symptoms and treatment of Charcot foot?
Charcot foot symptoms can include:
- Redness or swelling of the foot or ankle
- The skin feels warmer at the site of the injury
- A feeling of deep aching
- Deformation of the foot
If an individual has a suspected or diagnosed Charcot foot, they should be referred immediately to a multidisciplinary foot care team. Treatment will involve reducing the pressure (or weight-bearing) and immobilising the foot in a plaster cast to allow it to heal in the correct position. The condition will be monitored by x rays and at regular appointments with a podiatrist.
Sufferers of Charcot foot and tissue damage through reduced blood supply are at high risk of limb-threatening infection. At the first sign of a new ulceration, wound, swelling or discolouration, the patient should be referred within 24 hours to a multidisciplinary foot care team for urgent treatment of their infection. Any delay can lead to amputation.
Boyes Turner’s clinical negligence team are experienced in acting for amputee clients who are living with serious disability caused by negligent medical treatment of diabetic complications, including Charcot foot.
If you have suffered or are expecting to undergo an amputation and would like to find out whether you have a claim, you can speak in confidence to one of our skilled amputation team at email@example.com.