If diabetics neglect the care of their foot, this can lead them to develop a diabetic foot syndrome and subsequently a Charcot foot. Failure to do so will make the damage incurable.

Therefore, the daily care of the feet and thus also the investigation of injuries are crucial in order to be able to start treatment on time. Only in this way can one avoid that one must live the rest of his life with an irreparable foot.

short version

  • The Charcot foot causes chronic changes in the ankles.
  • Closely associated with diabetic foot syndrome and neuropathy or polyneuropathy.
  • Water retention (edema) marks the beginning of the destruction of the foot skeleton.
  • Patients often do not notice the condition because they no longer feel any pain.
  • Only people with a severe sensory disorder can develop a Charcot foot.
  • Once the foot is destroyed, absolute healing is no longer possible.
  • Regular care of the feet and an optimal adjustment of the blood sugar level are necessary to prevent the development of a Charcot foot.

What is a charcot foot?

A Charcot foot is a serious complication triggered by diabetes mellitus. The Charcot foot marks the end of a series of chronic changes in the ankles and is basically based on the results that polyneuropathy can cause.

Closely associated with polyneuropathy is diabetic foot syndrome. Diabetic foot syndrome suffers from nerve damage or circulatory disorders.

This leads to a diminished or completely absent sensation of pain. The big problem that makes the emergence of a Charcot foot so problematic is that the condition is not painful.

This is due to the lack of pain that is triggered by the diabetic foot.

This is how a charcot foot is made!

At the beginning there is a diabetes-induced neuropathy or polyneuropathy. Associated with the dissolution of the bone and a permanently elevated blood sugar level, it comes to the bones of the ankle are attacked and destroyed.

Often, this destruction process begins with a pain-poor and load-dependent inflammatory water retention (edema). These water retention are usually traumatic.

This leads to a so-called fatiguing trauma that is triggered due to recurring loads. This strain leads to damage to the bone, which in turn means that the body’s own repair processes can no longer be compensated.

In short, this means that injury heals very slowly in the long term. If, due to polyneuropathy, it is noticed too late that you have problems, it is often too late for a successful cure.

The fatigue trauma leads to a so-called bone destruction (bone dissolution).

examination for swelling and redness

It is very important to pay attention to the following things! First of all, the foot must be examined for swelling and redness.

Patients who do not suffer from neuropathy or polyneuropathy would immediately notice that something is wrong with their foot. For patients who suffer from it, it looks completely different.

Your lack of pain perception ensures that you often do not notice any problems that arise. Therefore, diabetics should pay particular attention to a lack of pain perception.

In short, you simply can not feel it when the ankle is gradually destroyed. It is therefore important to go to the specialist immediately if you notice that you are suffering from one of the symptoms.

It is also important that you should act preventively rather than later suffer years of the consequences of a destroyed ankle.

The current state of research is based on two causes!

Nevertheless, it can be said that the causes are still not fully understood. According to the current state of research, two mechanisms are considered extremely possible, which contribute to the creation of a Charcot foot.

On the one hand, this is the mechanical disorganization of the ankle, which leads to small fracturesin the bone structure (microfractures). On the other hand, increased blood flow can cause so-called hyperfusions, which lead to bone softening.

Bone softening leads to instability of the affected bone area in the foot. This, in turn, leads to a collapse of the arch of the foot and to the development of a pronounced flat foot.

A bone change can affect all areas of the ankle. As already defined above, the acute stage is characterized by swelling, redness and overheating.

If the foot is not relieved and continues to be heavily loaded, it can lead to severe misalignments, that is to say deformations of the foot skeleton. Pressure overloads are often the cause of the development of soles of the feet ulcers. These are called in technical language as ulceration.

The deformed bone skeleton and the frequent appearance of ulcers lead to a neuropathic foot deformity. The analgesia due to the nerve disorder causes the patient to notice the collapse of the foot skeleton and also skin injuries often too late.

The Charcot foot is triggered by the following diseases:

  • Diabetic polyneuropathy
  • congenital or acquired neuropathies
  • syphilis
  • syringomyelia
  • meningomyelocele

Neuropathy and diabetes are the main risk factors for the emergence of a charcot foot!

Generally it can be said that only people suffering from a severe sensory disorder can develop a Charcot foot. Another condition for the emergence of this condition is that the foot must be in daily function.

This is especially so because overloading is one of the main triggers. It can be said that the diabetic foot syndrome and thus the neuropathy are the main triggers.

But beware! Patients suffering from neuropathy but not diabetes can also develop a Charcot foot.

A timely relief of the resulting damage leads to a complication-free healing. However, a failure to do this relief means that a cure or a treatment are only very limited possible.

An early treatment is crucial for your success!

Neglecting treatment is often associated with deformities and joint stiffness. A normal gait is then usually only limited possible. As already noted, the Charcot foot is the final stage of extreme overuse of the foot.

An overload damage is expressed in three stages. In the first stage it comes to a bone dissolution. This describes the acute Charcot foot characterized by swelling, redness and overheating.

In the second stage, a growing together of the bones can be observed. Bone and joint changes are commonplace here. The third stage is again characterized by bone consolidation or remodeling of the bones. This is where the typical foot deformities occur.

The Charcot foot can in turn be divided into five different types. These are listed here:

  • Type I (involvement of toes and forefoot)
  • Type II (in case of impairment of the so-called Lisfranc joint between the tarsal and midfoot bones)
  • Type III (if the joint between heel and cuboid bone is affected)
  • Type IV (with involvement of the upper ankle)
  • Type V (when heel and lower ankle are affected)

Therapy and treatment of the Charcot foot

When it comes to infections of soft tissue and bone, surgical wound treatmentimmobilization and treatment with antibiotics is absolutely necessary. It is also important to know that the Charcot Foot can not be treated surgically. Therefore, healing of the infection can only be accomplished by plastering the foot or immobilizing it with a 2-cup orthosis.

If the foot shape and structure of the skeleton are maintained, the foot can be fitted with an orthopedic custom shoe. If the arch breaks in, the foot must be completely relieved for several months. Only then can it be begun to correct the misalignments by means of orthopedic shoes.

A timely prevention can save a lot of trouble!

Once the foot is destroyed, healing can no longer be achieved due to the massively destroyed, disintegrated or broken skeleton architecture. However, this can be prevented. Once it is determined that a Charcot foot is emerging, the foot skeletal injury must be dealt with immediately.

Persons suffering from neuropathy or polyneuropathy must be made aware of the risk of developing a Charcot foot as a result of diabetic foot syndrome. In other words, it is important to prevent the fatigue trauma in advance and to relieve and maintain his foot regularly.

In order to optimally counteract the development of a Charcot foot, certain measures should be taken. For diabetics, the correct adjustment of the blood sugar level is of crucial importance. This must be checked regularly and should, if at all, contain only slight fluctuations.

Regular foot care, foot exercises and examining for injuries and pressure points help with the treatment

Furthermore, a regular foot care, also important from the podiatrist. This is because it can be ensured that injuries are recognized early. In everyday life you should also resort to stable and comfortable shoes.

To stay mobile in the long term, it makes sense to do foot exercises. This helps to keep the joints flexible and also minimizes the risk of injury to the feet.

Regular movement also stimulates blood circulation and makes the joints more resilient. But beware!It should always be ensured that the foot is not overloaded.

Diabetics should regularly check their feet for injuries and bruises and use care products as well. These may be, for example, ointments, diabetic socks or even wearing diabetic shoes.

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