Charcot collapse of the foot and ankle is a very difficult and often debilitating problem related to diabetes. Most, if not all, patients who develop charcot of the foot and ankle have diabetes and neuropathy or numbness of the foot. With trauma or abnormal stress to the foot, there is a small injury that escalates as the patient cannot feel their foot and ankle and so has limited to no pain.
Over time, there is a collapse of the foot or ankle and the formation of ulcers or angulation deformity. It is essential to treat the charcot episode rapidly and, if possible, prior to collapse, angulation or ulcer formation.
Early treatment of charcot problems deals with calming of swelling and protection of the foot and ankle. This is performed with casting or bracing. In cases of early collapse or looseness of the joints, it may be necessary to use the Ilizarov fixator to correct foot alignment and hold the foot during healing.
Delayed charcot treatment once the fractures have healed deals mainly with removal of spurs and protection of the foot from ulcer formation and deformity. Bracing and cushioned shoes and insoles are essential treatment options. If severe deformity or looseness exists, there may be a need to realign or correct the position of the foot. The Ilizarov fixator is used to realign the foot and allow some weight during the healing period.