Brandt R Gibson, DPM
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Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute

Charcot is a condition that occurs primarily in diabetics with neruopathy.  For various reasons, the bones in the foot become very fragile.  They start to fracture under any pressure at all.  This initial fracturing phase can go on for several months.  Since it occurs with neuropathy, there is usually no pain, but there is redness, warmth and intense swelling.  

After the initial breaking phase is over, there is a consolidating phase for the next few months where the bones reach a point where they stop breaking.  They then begin to consolidate back into solid bones.

The last phase is the remodeling phase. During this phase, the bones become stronger and reform permenantly.  The bones of the foot assume a new "rocker" shape, where the bottom of the foot is now convex rather than the origional concave.  Balance may become a problem and orthotics and special shoes will likely be needed. The foot will be deformed and surgery is a possibility, although in some cases the risks may outweigh the benefits.

It's important to see your podiatrist if you are experiencing syptoms of charcot, because the earlier it is caught, the less damage will be done to the foot.  The patient can get into a non-weight baring cast and use crutches or a wheelchair during the initial phase of the process. Then a supportive boot may be worn while the bones reconstruct.  This will result in less of a rocker shape and less damage to the bone structure. 

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