Learn About Sneaky Foot Disease- The New Indian Express

Learn About Sneaky Foot Disease- The New Indian Express

express news service

KOCHI: Charcot foot is a bone and joint disease that affects the foot and ankle region and causes bone fragmentation and destruction, leading to permanent deformities, loss of limbs, and other morbidities . The most common cause is diabetes, complicated by neuropathy. It begins harmlessly as simple swelling with heat and is often mistreated and misdiagnosed as cellulitis or infection.

The limb slowly changes shape, but the patient is not aware of the changes until it becomes severe and causes instability or difficulty walking. It is painless and therefore often ignored. The incidence of Charcot foot problem in India is 5% to 9%. In particular, the country’s adult diabetic population is expected to increase to 73 million by 2025. The volume of patients with Charcot’s disease would exceed the total population of a country such as, for example, Denmark.

However, Charcot ailments can be treated with a better understanding of the disease. In the early stages, simple off-loading casting techniques save the limb from progression of the deformity. Once the deformity has set in, custom footwear and Charcot Restraint Orthotic Walkers (CROWs) help save feet from further trouble.

In those feet where the deformity has become severe with a non-healing wound, major surgical repair would be needed. The most important goal is to avoid limb amputation.

What are the causes?
The exact reason why bone destruction is triggered is unknown, but it usually occurs in feet that have neuropathy (nerve damage), with some disturbance of blood flow. The bone begins to fragment with some trivial injury. However, no pain is felt; we call this loss of protective sensation (LOPS).

treatment options
Is there any medication? No. Unfortunately, no specific medication is helpful in preventing or treating this. The disease cannot be reversed to normal, but the devastating deformity can be prevented simply by offloading in a suitable total contact cast. One may need prolonged offloading therapy and proper diabetes management. In case of an already developed deformity or ulcer with deformity, staged surgical intervention can save the limb and help to walk almost normally.

The writer is a senior consultant (foot and ankle), trauma and arthroscopy surgeon, and president of the Indian Foot and Ankle Society.

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