Charcot Foot Deformity - Orange County
X-ray showing significant rigid Charcot foot deformity, in which the patients foot was not "braceable". Orange County, CA.
The initial signs of Charcot foot in Orange County are non-specific and are more typically seen in other more common conditions.
Many Orange County Charcot foot deformity patients do not have pain or have pain from neuropathy that was preexisting.
Charcot Foot Deformity in Orange County
Charcot arthropathy, also known as Charcot foot and ankle, is a syndrome in patients who have a loss of sensation (neuropathy). It includes fractures and dislocations of bones and joints that occur with minimal or no known trauma. Our Orange County Podiatrist / Foot and Ankle Surgeon can help with your Charcot Foot Deformity in Orange County at our Irvine, CA, Newport Beach, CA, Huntington Beach, CA or Orange, CA offices.
Symptoms and Clinical Presentation
Initially, there may be swelling, redness, and increased warmth of the foot and ankle. Later, when fractures and dislocations occur, there may be severe deformities of the foot and ankle, including collapse of the midfoot arch (often called rocker bottom foot) or instability of the ankle and hindfoot. The syndrome progresses through four general stages:
•Stage 0 (prodromal): increased warmth, dull pain, swelling, and joint instability; normal appearing bone and joints on radiographs.
•Stage 1 (acute, fragmentation): marked redness, swelling, and warmth; early radiographs show soft tissue swelling and may show bony fragmentation and joint dislocation.
•Stage 2 (subacute, coalescence): decreased redness, swelling, and warmth; radiographs show early bony healing.
•Stage 3 (chronic, reconstruction-consolidation): redness, swelling, and warmth resolved; bony healing or nonunion and residual deformity are frequently present.
Cause of Charcot Foot Deformity (including risk factors)
Charcot foot may occur in patients with peripheral neuropathy resulting from conditions including diabetes mellitus, leprosy, syphilis, poliomyelitis, chronic alcoholism and others. Repetitive microtrauma that exceeds the rate of healing may cause fractures and dislocations. Changes in circulation may cause resorption of bone, weakening the bone and increasing susceptibility to fracture and dislocation.
Anatomy of Charcot Foot Deformity in Orange County
Charcot arthropathy in Orange County may affect any part of the foot and ankle, including (in decreasing order of frequency) the midfoot, hindfoot, ankle, heel, and forefoot. Multiple regions may be involved concurrently. Fractures and dislocations frequently involve several bones and joints, with extensive fragmentation and deformity.
Diagnosis of Charcot Foot Deformity in Orange County
Time between onset of symptoms and diagnosis may be several weeks or months. Delay in diagnosis may or may not affect the end result because gross instability may occur even if prompt diagnosis is made. Diagnosis is based on a high index of suspicion for this problem in patients with neuropathy. Increased redness, swelling and warmth may be the only early signs. Some patients have pain. Early radiographs may show soft tissue swelling with no bony changes, but repeat radiographs several weeks later may show bone and joint changes.
Treatment Goals of Charcot Foot Deformity in Orange County
The goal of Charcot treatment is to stop the progression of the deformity, avoid foot wounds and ulceration, and maintain a "braceable foot", which will allow the patient to maintain the ability to walk.
Non-Surgical Treatment Charcot Foot in Orange County:
Non-operative treatment includes a protective splint, walking brace, custom orthotic devices, or casting. After stable healing is noted, treatment includes accommodative footwear with protective orthotic devices and accomodative shoes.
Surgical Treatment of Charcot Foot and Ankle Deformity in Orange County:
If conservative treatment fails, several reconstructive surgical options may be considered. These options can range from the removal of bony prominence that may cause an ulcer to advanced reconstructive surgery consisting of foot and ankle realignment, fusion, or external fixation devices.
Please contact our office in Irvine, Orange, Newport Beach, or Huntington Beach in Orange County, CA to make an appointment with our foot and ankle surgeon / podiatrist (Dr. Coyer) to have your Charcot Foot Deformity in Orange County fully evaluated and treated.