Dr. Thomas Rocchio, Senior Partner at PA Foot and Ankle Associates, is one of the nation’s leading experts on Charcot Foot disorder in diabetic patients.
Dr. Rocchio is board certified in foot surgery, and board certified in Rearfoot and Ankle reconstructive surgery. He is a Fellow of the American College of Foot and Ankle Surgeons (FACFAS); Fellow of the American Professional Wound Care Association (APWCA); and Member of the APMA.
Doctor Rocchio was brought up in a new era of limb salvage – he believes in limb preservation. With the skills of his training and vast experience, a life threatening, infected Charcot foot is reconstructed to become truly functional.
About Charcot Foot disorder (Charcot Arthropathy):
Diabetic patients who suffer from peripheral neuropathy are those most likely to develop Charcot Foot disorder, which can lead to severe deformity, disability, and amputation.
Diabetes damages blood vessels, which consequently decreases blood flow. Diminished circulation weakens bone. When blood flow is compromised in the feet and ankles, bones and joints may disintegrate. As a consequence, diabetics are at high risk for breaking bones in their feet.
Unfortunately, persistent high blood sugar from diabetes also damages nerves, leading to diabetic peripheral neuropathy, a loss of sensation in the lower leg, foot, or ankle. DPN results in a dimished ability to feel sensations like hot, cold, pain, or trauma, and causes other symptoms as well.
When a patient with diabetic peripheral neuropathy fractures a bone in their foot, they may not realize it, due to the loss of sensation. They continue to walk on the foot, which causes severe fractures and joint dislocations. When sharp edges of broken bone press against the bottom of the foot, chronic sores occur, and the risk for infection is high.
As the bones and joints disintegrate and the foot is subjected to further trauma, the shape of the foot may become deformed, taking on a “rocker bottom” appearance. This is Charcot arthropathy, one of the most serious complications of diabetes.
Symptoms of Charcot foot include
- Foot is warm to the touch (warmer than the other)
- Redness and swelling
- Pain or soreness
Charcot foot can be treated successfully without surgery, but it’s essential to follow your podiatric surgeon’s recommendations to avoid amputation of a toe, foot, or leg.
Non-surgical treatment for Charcot foot may include
- Immobilization: Because the foot and ankle are so fragile during Charcot, they must be protected so the weakened bones can repair themselves. Complete non-weightbearing is necessary to keep the foot from collapsing further. This may be accomplished with a cast, removable boot or brace, crutches, or a wheelchair. It may take the bones several months or longer to completely heal.
- Vigilant monitoring of symptoms: It’s essential that a patient with Charcot Foot disorder inspects their foot daily and sees their podiatrist or podiatric surgeon as scheduled. Infection can appear suddenly and compromise the health of the foot in as little as 24 hours.
- Custom shoes and bracing: After the bones have healed, custom orthotic inserts may be recommended to help the patient return to daily activities and to prevent a recurrence of Charcot foot. If the patient has suffered a permanent deformity, bracing may be required.