Charcot foot is a serious condition that affects people with diabetes, specifically those who have nerve damage in their feet (called neuropathy). When this happens, people lose the ability to feel pain, which makes them more likely to injure their feet without realizing it. Over time, these injuries can cause bones in the foot to break or become misaligned, leading to deformities and even ulcers (sores on the skin).
Charcot foot is challenging to treat, but with the right care, surgery can help save the foot and allow patients to walk again. Here’s a breakdown of what you need to know:
What is Charcot Foot?
Charcot foot happens when nerve damage prevents people from feeling pain in their feet. Without this pain, minor injuries like small fractures can go unnoticed. As these injuries accumulate, they lead to deformities in the bones of the foot, making it harder to walk and increasing the risk of ulcers. In severe cases, Charcot foot can lead to amputation, where part of the foot or leg is removed.
How is Charcot Foot Treated?
There are several ways to treat Charcot foot, and the goal is to stabilize the foot, reduce pain, and make it possible for the person to walk without issues. The main types of treatments include:
Exostectomy (Bone Removal): Sometimes, there are bone bumps in the foot that can cause ulcers (sores). Removing these bumps can help the ulcers heal and prevent them from coming back.
Tendon Balancing (Correcting Tendon Problems): Tendons are the tissues that connect muscles to bones. When they get too tight, they can cause the foot to be misaligned, which makes walking harder. A common procedure is to lengthen the Achilles tendon (the one in the back of the ankle) to help restore the foot’s natural position.
Reconstruction (Surgical Repair): In more severe cases, surgery is needed to realign the bones and stabilize the foot. Doctors use screws, plates, or special rods to hold the bones in place while they heal. Sometimes, a combination of inside and outside devices (called internal and external fixation) is used to keep the foot stable.
Computer-Assisted Correction: New technology helps doctors make very precise corrections to the foot. This allows for a more accurate adjustment during surgery, improving the results.
What Are the Risks and Benefits?
As with any surgery, there are risks. After surgery, patients might face complications like infections, problems with wound healing, or the bones not healing properly. But, the good news is that, with modern surgical techniques, many people see good results. The goal is to:
- Heal ulcers (sores) that don’t go away with other treatments.
- Allow the foot to return to a more normal shape so it can fit into shoes
- Enable patients to walk without pain and prevent further injuries
- Amputation and Recovery
Surgical treatment for Charcot foot has helped reduce the need for amputation (removing part of the foot or leg). In fact, studies show that only about 5.5% of people who have surgery for Charcot foot need an amputation. After surgery, most patients (about 91%) are able to walk again, which is a huge improvement compared to before.
Recovery from surgery can take time. It’s important for patients to work with a team of healthcare professionals, including nurses, physiotherapists, and foot specialists, to help them heal properly and get back on their feet.
Conclusion
Charcot foot is a serious condition, but with the right treatment, it is possible to prevent amputation and help people regain their ability to walk. Surgery is an important option for many people, and while there are risks, the outcomes are generally positive, allowing patients to lead a more active and pain-free life.
Do you have more questions?
Q. What is Charcot Foot?
A. Charcot foot is a serious condition that affects people with diabetes and neuropathy, where nerve damage leads to the inability to feel pain in the feet, resulting in unnoticed injuries and deformities in the foot bones.
Q. How is Charcot Foot treated?
A. Treatment for Charcot foot aims to stabilize the foot, reduce pain, and make it possible for patients to walk. Treatment methods include bone removal (exostectomy), tendon balancing, reconstruction using screws and plates, and computer-assisted correction for precise adjustments.
Q. What are the risks and benefits of Charcot Foot surgery?
A. Risks include infection and poor bone healing, while the benefits include healing ulcers, returning the foot to a normal shape, and preventing amputation. Studies show that only about 5.5% of patients require amputation after surgery.
Q. What is the recovery time after Charcot Foot surgery?
A. Recovery can take several months, with most patients able to walk again after surgery. Full recovery and the ability to engage in normal activities depend on rehabilitation and follow-up care.
Q. What are the causes of Charcot Foot?
A. Charcot foot occurs when nerve damage, often from diabetes, leads to an inability to feel pain or discomfort, which allows minor foot injuries to go unnoticed and result in joint and bone deformities.
Q. How can Charcot Foot lead to amputation?
A. If untreated, the deformities and ulcers caused by Charcot foot can become severe, increasing the risk of infection and requiring amputation of part of the foot or leg.
Q. Can Charcot Foot be prevented?
A. While Charcot foot can be difficult to prevent, managing diabetes effectively, regular foot care, and addressing injuries early can help reduce the risk of developing the condition.
Q. What are the symptoms of Charcot Foot?
A. Symptoms include swelling, redness, warmth, and a collapsed arch in the foot, often accompanied by pain or deformity. However, many patients experience little to no pain due to nerve damage.
Q. How is Charcot Foot diagnosed?
A. Diagnosis is made through a combination of clinical evaluation, imaging studies like X-rays, MRI, or CT scans, and sometimes bone scans to assess the degree of bone damage and deformity.
Q. Can Charcot Foot occur in people without diabetes?
A. Yes, while Charcot foot is most common in diabetic patients, it can also occur in individuals with other conditions that lead to nerve damage, such as spinal cord injuries or peripheral neuropathy.
Q. Is surgery always necessary for Charcot Foot?
A. Surgery is not always required but may be necessary for severe deformities or when conservative treatments like immobilization and custom footwear do not alleviate symptoms or prevent further complications.
Q. What are conservative treatments for Charcot Foot?
A. Conservative treatments include rest, immobilization with a cast or brace, and wearing custom shoes or orthotics to stabilize the foot and prevent further damage while allowing the bones to heal.
Q. Can Charcot Foot be treated without surgery?
A. In the early stages, Charcot foot can often be managed without surgery through proper offloading, custom footwear, and close monitoring. Surgery may be required for advanced cases or when conservative measures fail.
Q. How does Charcot Foot affect mobility?
A. Charcot foot can significantly impact mobility if not treated, causing deformities that lead to difficulty walking, imbalanced gait, and increased risk of further foot injuries or ulcers. Early intervention can help maintain mobility.

Dr. Mo Athar