Diabetes Increase Results in More Charcot Cases

Dr. Jake McLeod

The Centers for Disease Control (CDC) reports that cases of diabetes are increasing at an alarming rate in the U.S., with an estimated 34.2 million Americans affected by the disease. While genetics plays a role in causing diabetes, the most common reasons for contracting it are lack of physical activity, obesity, and poor diet.

Jake McLeod, DPM, of Longview Orthopedic Associates reports that local cases are mirroring the national trend, with the increase in diabetes causing a similar increase in a condition known as Charcot foot.

“Profound peripheral neuropathy, which is a requisite to developing Charcot deformity of the foot, is most frequently attributed to diabetes,” McLeod said, “particularly for patients who have had diabetes for an extended period of time.” Symptoms include swelling, pain, numbness, and weakness.

The focus of initial treatment for patients with acute Charcot is to stabilize the foot in either a cast or a removable CAM (controlled ankle motion) boot to minimize weight-bearing. This typically lasts four to six weeks. Compression wraps may also be used to help reduce swelling.

“If the deformity is stable and there is no significant soft tissue breakdown, patients can then be treated conservatively with a CROW (Charcot restraint orthotic walker) boot.” McLeod said. “However, if the situation involves certain joints or is grossly unstable, or if there is an infected wound that will not heal because of the deformity, surgery is often warranted.”

He cautioned that surgery has risks for these patients. “If complications arise, such as a bone infection, patients are likely to lose their leg, which is why it is so important to recognize the condition as early as possible so that it can be treated appropriately.”

Dr. McLeod is double board certified in foot surgery and reconstructive ankle surgery. For more information call Longview Orthopedic Associates at 360.501.3400