Charcot Arthropathy Treatments

How is Charcot Foot Treated?

Treatment of Charcot Foot varies according to the needs of the individual person and the stage of the disease. Your doctor and Certified Orthotist will recommend the most appropriate treatment based on your specific needs. The purpose of treatment is to protect the fractured bones and to maintain the position of the joints. This will allow proper healing and prevent deformities that may lead to ulceration (sores on the feet).

Treatments options include:

Non-weight bearing – In most cases, keeping pressure off the foot is very important. Removing pressure from walking or standing by keeping your foot up will allow for proper healing.

Total contact cast (TCC) – A TCC is a type of cast that is made from fiberglass or plaster. The Certified Orthotist or casting technician applies the cast to your foot and leg to immobilize the joints. The TCC provides excellent protection to the Charcot Foot. Since there is no way to check the skin without removing the cast, there is a risk of developing ulcers.


Removable cast walker (RCW) – A RCW is a type of brace that is used in place of a TCC.  The RCW is designed to immobilize the foot and ankle like a TCC but can be removed to check the skin or change dressings on an ulcer.  There are many different types of RCW available includingthe Ossur Rebound Walker (Figure 2) or the Aircast Walker.


Charcot Restraint Orthotic Walker (CROW) – The CROW walker is a custom made ankle foot orthosis or brace that is made from a plaster mold of the foot and ankle. It is used to immobilize the foot and ankle for patients who have severe deformities or ulcers.


What Can You Do?

Successful treatment of the Charcot Foot depends on immediate appropriate care that lasts throughout the entire disease process. The most important things to remember are:

  • Listen to your doctor
  • No weight bearing without your cast, RCW or brace until the bones are completely healed.
  • Carefully inspect your skin at least two times a day looking for any red marks or pressure points. See your doctor as soon as possible if there is any skin breakdown.

Summary

Stage Description Orthotic Treatments
0

- Loss of protective sensation
-  Injury (such as twisted ankle)

TCC, RCW, orthopaedic shoes, foot orthoses
1

-  Destruction phase

-  Bone fractures and joint dislocations are seen on x-rays

TCC, RCW, CROW
2

-  Destruction stops and healing starts

TCC, RCW, CROW
3

-  Bones become fixed and stable

RCW, CROW, orthopaedic shoes, foot orthoses