Charcot neuroarthropathy is a potentially debilitating condition associated with diabetes, causing the bones of the foot to shatter. The reason why Charcot develops is not completely known. It is much more common in neuropathic (loss of sensation in the feet) diabetic patients who are insulin-dependent and has been for 10 or more years.

When Charcot develops, there is an influx of blood flow to one certain area of the foot or ankle, which eventually leads to the calcium and other minerals of the bone being washed away. The acute phase of Charcot last 1-2 weeks, and is exhibited by significant swelling, redness, and heat produced by either the entire foot or a particular region of the foot or ankle.

If a diabetic, neuropathic patient ever notices either one particular area over the entire foot or ankle appearing very red, swollen, and feeling warm to touch, they should immediately discontinue placing weight on the foot and start using a walker or crutches absolutely at all times, with evaluation by a foot specialist immediately.

During the acute phase of Charcot, if weightbearing continues, the joints and bones of this region of the foot can become very brittle and fracture into multiple shards of bone, resulting in severe deformity of the foot. If immediate nonweightbearing is assumed immediately when the foot or ankle is noted to be red, hot, and swollen, the destruction and deformity often associated with Charcot can be avoided.

Typically during the acute phase of Charcot, nonweightbearing is required for up to 4 weeks. If x-rays appear that the acute phase is pending, then the weightbearing can be resumed, with some extra compression such as with compression hose to minimize swelling and some protection in a walking boot or walking cast.

It is the deformities associated with Charcot that often lead to other chronic diabetic foot wounds, which can lead to other significant problems including the need for amputation.

Maintaining regular visits with a physician to monitor glucose levels, and regular visits with a foot specialist can help prevent the deformities and Associated problems of diabetes.

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