Charcot Foot

Comfort Shoe Specialists of St. Louis are experts at assisting physicians and their patients maintain healed Charcot deformities.

Charcot Foot refers to the damage of the joints that occur in a neuropathic foot. Diabetics are prone to this condition due to autonomic neuropathy and hyper vascularity. The result is a weakened bone (osseous) structure. An undetected injury such as a stress fracture, rupture of a ligament or sprain can result in chronic swelling and damage to the supporting foot structures. The foot may collapse with weight bearing of normal walking since the neuropathy causes LOPS or Loss of Protective Sensation. The architecture of the foot is rearranged so that the arch may become inverted, causing a rocker bottom foot.

NOTE: If foot lacks sensation and is hot, swollen, and/or red, see a physician immediately. Often early detection and treatment by physicians specializing in Charcot foot with serial casting will result in a more normal shaped foot. Time is important!

Rocker bottom foot does not match the shape of any standard shoes so breakdown of the tissue will occur. Since there is LOPS or loss of protective sensation, activity is generally not curbed and the deformed midfoot will break down with repeated micro-traumas of tissues that are not designed to sustain the repeated stress of steps, such as the heel and forefoot.

The danger is that an open wound is susceptible to bacteria that can lead to infection, dangerous since blood supply may be compromised for healing.

Charcot foot disease can affect the forefoot or rearfoot. Osteomyelitis, arthritis, and soft tissue infections are conditions which can be confused with Charcot Foot Disease.

Comfort Shoe Specialists of St. Louis Pedorthic Problem Foot Solutions for closed ulcers:

  • Properly Fit Footwear
  • Accommodative total contact orthotics devices, often using closed cell and washable orthotic coverings
  • Increase width and depth of footwear, particularly the midfoot
  • Custom Made Footwear, usually high tops over the ankle bones
  • Rocker Soles to reduce movement of the foot joints to protect from stress fractures and overuse
  • Carbon fiber or full steel shanks to prevent over extension or to mimic forefoot in the case of amputations

The “Gold Standard treatment” with many practitioners is total contact serial casting for open ulcers. This aggressive approach assists patients to realize the seriousness of the situation so they will reduce activates, elevating limb appropriately and heal before resuming normal activities.

Comfort Shoe Specialists of St. Louis Pedorthic Problem Foot Solutions for open ulcers:

  • Closed cell and washable orthotic material on total contact custom orthotics with elevated areas to reduce pressure at ulcer site
  • Custom Healing Sandals
  • Custom Molded Footwear, usually chukka height
  • Rocker soles with full steel shanks for rigidity to reduce joint movement and enable foot healing
  • Diabetic Socks such as Thorlo Medds