Tuesday, April 9, 2013

Grapevine Man Loses Leg from Diabetic Charcot

Are you diabetic with neuropathy?  If you are, then you know all about charcot.  Never heard of it?  Well, listen up.  This disorder is one of the leading causing of limb loss for a diabetic patient.  And it is the reason a patient of ours recently lost their leg.

Charcot (pronounced shark-o) is the break down of bones at the joint level causing deformity of the foot or ankle.  It occurs when the nerves around the joint are not longer functioning properly, thus preventing the feedback mechanism of pain.  Pain is what tells you that your shoes are too tight, you are walking too much, your shoes are uncomfortable, your arches are falling, etc.  Without this mechanism, you continue to walk and not know you are breaking down your joints.

This breakdown continues with each step eventually resulting in fractures or broken bones, dislocated joints and a deformed look to the foot.  The joints most affected are in the arch or center part of the foot.  This break down can cause severe dislocation that results in a large bump on the bottom of the foot that we refer to as "rocker bottom".  This prominence can then be a pressure point on the inside of the foot leading to ulcers that then lead to infection.  And if you've read previous posts, infection is the number one reason you will lose your leg as a diabetic.

How do know if you have Charcot?  Warning signs include:
- a very swollen foot and leg that started suddenly without an opening in the skin or any signs of infection
- the foot is starting to change shape, which occurs rather quickly
- a clicking sound when you walk barefoot (this is you walking on a dislocated joint)
- pain when you normally don't have much feeling in your feet

If you think you may have Charcot:
-  ice and elevate your foot
- don't walk barefoot
- apply an ace bandage or wear a compression sock to reduce swelling
-  call our office for immediate evaluation.  Charcot can often be confused with infection and vice versa.  A complete exam with xrays is necessary. Often you will be required to stay off the foot and wear a tall boot until the acute phase has passed.  After that, we will devise a plan to attempt further breakdown of the foot and possible amputation.

The best thing you can do to save your legs is see a podiatrist.  Call us today.