Diabetes is one of the biggest health and lifestyle challenges affecting people in the UK. One in ten people over the age of 40 now have type 2 diabetes, with 4.8million sufferers of diabetes of all types across the UK. Leading diabetes charity, Diabetes UK, estimates that by 2025, 5.3million people in this country will be affected by the condition. Having diabetes increases an individual’s risk of complications, such as heart disease and stroke, sight loss, sexual problems, nerve damage (neuropathy) and amputations. One of the lesser known serious complications of diabetes and potential causes of lower limb amputation is a condition called Charcot foot. What is Charcot foot? Charcot foot is a serious condition in which the bones of the foot or ankle degenerate and become deformed. It is sometimes known as Charcot arthropathy. Arthropathy means disease of a joint. Charcot foot is most common in people who can’t feel their feet properly. It is most often seen in people with diabetes who have reduced sensation in their feet from diabetic neuropathy. It is thought that around 0.3% (or 3 in 1000) of diabetic patients who have peripheral neuropathy (loss of sensation) develop Charcot foot. The condition is associated with earlier death in 28% of those affected. Common signs of Charcot foot include swelling, redness and increased warmth of the skin from inflammation, and progressive deterioration of the foot and ankle’s weight bearing joints. What causes Charcot foot? The condition arises from a combination of factors associated with diabetes. Diabetics with neuropathy have less feeling in their feet. They 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 feel 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. If signs of Charcot foot are ignored or incorrectly treated, this can lead to permanent disability and amputation. 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. A quarter (25%) of patients who develop signs of Charcot foot have suffered trauma to the joint (such as a twisted ankle or knock) within the previous four weeks. Acute Charcot foot sometimes follows an inflammatory condition, such as infection, conditions like thrombosis which affect the blood vessels, or after an operation or surgery. Who is at risk of Charcot foot and resulting disability? Anyone with diabetes is 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 if they already have ulcers 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. This includes 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 feeling in their feet they must check their feet daily. This ensures that they notice minor injuries as soon as they happen and can seek help straight away. 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 blisters 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: antibiotics advice to rest the foot a review of their diabetic medication and management referral to a foot-care specialist a personal care plan Medical negligence compensation claims arising from Charcot foot Medical negligence compensation claims for injury from Charcot foot may arise from: a doctor’s delay or failure to recognise signs of Charcot foot failing to treat signs of infection or ulceration misdiagnosis of Charcot foot, such as incorrectly assuming merely a sprain, DVT, cellulitis or rheumatoid arthritis failing to refer the patient with signs of Charcot foot to a multidisciplinary foot clinic or specialist clinic delay or failure to ensure the patient rests, immobilises (in a cast) or keeps their weight off the foot failing to monitor the progression of the condition (including with x-rays) delay, failure, incorrect operative technique or post-operative care, in cases where surgery is needed What compensation can I claim for Charcot foot? Negligent medical care of Charcot foot can cause permanent disability, including amputation, which reduces the patient’s mobility and independence, ability to work, participate in family, social and leisure activities. This can lead to depression and psychological injury and can cause financial hardship. Boyes Turner’s clinical negligence team are experienced in recovering early interim payments and full compensation for amputee clients who are living with serious disability caused by negligent medical treatment of diabetic complications, including Charcot foot. Each client’s injury and circumstances are unique, and their compensation is tailored to meet their individual needs, but often includes compensation for: pain and suffering and disability from the injury costs of care prostheses (artificial limbs etc) rehabilitation costs of necessary domestic assistance therapies, such as OT or physiotherapy psychological counselling adaptations to home specialist or adapted vehicles, equipment and aids loss of earnings and pension medical costs other losses and expenses arising from the avoidable disability. 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 mednegclaims@boyesturner.com.
