Diabetic (Charcot) Foot | Orthopaedics | Loyola Medicine

Diabetic (Charcot) Foot

Leading-edge Program for Treating Diabetic Foot Problems

Loyola Medicine has one of the leading programs in the country for treating diabetic foot (Charcot foot) problems. Diabetic foot, also called Charcot foot or Charcot arthropathy, is a foot deformity most common in diabetes patients, especially those with nerve damage (neuropathy) and poor circulation. It affects the bones, joints and soft tissues of the foot and ankle. It can make walking difficult, lead to bone loss and in severe cases may require amputation. 

Damage to the nerves dulls awareness and reduces pain, making it harder for you to realize when you’ve had a foot injury. Charcot foot also may change the way you walk, forcing your feet and ankles to adopt unnatural positions. This can lead to foot ulcers and sometimes severe deformities. Reduced blood flow to the feet also deprives the tissue of the oxygen that it needs to stay healthy, hampering your immune system and making it harder for wounds to heal. 

Loyola takes an integrated approach to care for diabetic foot, combining the expertise of orthopaedic surgeons, podiatrists, endocrinologists and other specialists. 

Why Choose Loyola for Diabetic Foot Care?

Loyola offers surgical options not available at other institutions, including the use of a circular external fixator, a metal frame that that secures the bones of the feet.

A member of Loyola’s orthopaedic team is a leading surgeon in the treatment of Charcot foot and is the most published foot and ankle surgeon in the nation on the condition. Loyola treats nearly 100 Charcot foot patients a year. 

The unique diabetic foot care program at Loyola focuses on helping diabetic patients manage and care for their feet, preventing minor problems from becoming a major health condition like Charcot foot. Through regular appointments, your Loyola healthcare team will look for potential foot problems and show you how to care for your feet and be aware of potential issues. Learn more about Loyola’s diabetic foot care program.

How is Diabetic (Charcot) Foot Diagnosed?

Early diagnosis of Charcot foot makes treatment much easier for the patient. A specialist will examine your foot, review your medical history and may also use imaging such as X-rays, MRI (magnetic resonance imaging) and bone scans to determine if the bones of your foot are deformed. Early signs of Charcot foot include redness, swelling and higher temperature of the foot.

How is Diabetic (Charcot) Foot Treated?

Treatment of diabetic foot focuses on healing your broken bones and preventing further deformity and joint damage. Some nonsurgical treatments may include activity changes and using a cast or cast boot to reduce swelling and protect your bones. It will be important for you to avoid putting weight on your foot until the bones begin to heal. Antibiotics are prescribed to treat bone infections (osteomyelitis) and to help with the healing of ulcers and other wounds. After swelling decreases, you may be prescribed a custom shoe or walking boot that will reduce the chance of developing foot ulcers.

Your Loyola doctor may recommend surgery if your foot deformity puts you at risk for foot ulcers or if protective footwear does not provide relief. Your doctor may recommend one or a combination of the following surgical options:

  • Achilles tendon lengthening — Stretching the tendon by making a series of small cuts
     
  • Osseous debridement — Removing damaged tissue and bone to promote wound healing
     
  • Plantar osteotomy — Cutting and removing damaged and infected bones from the sole of the foot
     
  • Realignment osteotomy — Fusion and repositioning bones in the foot to promote stability
     
  • Selective or extended arthrodesis — Surgically fusing or immobilizing joints, such as the ankle, to stabilize the foot

Loyola provides a unique treatment for patients following surgery for diabetic foot, where a circular external fixator—a rigid metal frame that consists of three rings that surround the foot and lower calf—provides support and stability for the foot. The rings have stainless-steel pins that extend to the foot and secure the bones. Patients who receive the external fixator often are able to bear weight and walk on the foot sooner.
 
The external fixator is one treatment provided by Loyola’s orthopaedic specialists in order to avoid amputation of a leg affected by Charcot foot. In some cases with severe damage or a serious infection, an amputation above or below the knee may be recommended. These patients are frequently able to walk pain-free with the use of a prosthesis.