Surgery to Treat Charcot Foot
Surgery may be necessary to treat severe deformities caused by Charcot foot. Structures within the foot can be reshaped and bony protrusions can be removed surgically to prevent recurring ulcers. After surgery, the foot is monitored for signs of infection (e.g., redness, swelling, warmth).
Osteoctomy is the most common surgical procedure used to treat Charcot foot. This procedure involves making a surgical incision on the bottom of the foot and removing abnormal bone growth and bone and cartilage fragments. In some cases, osteoctomy can be performed on an outpatient basis, but it may require an overnight hospital stay. Local or general anesthesia is used. After the procedure, the patient usually wears a brace of cast for about 4 weeks, or until healing is complete.
Midfoot realignment arthrodesis is performed to remove bony overgrowths and repair the collapsed arch. This procedure requires general anesthesia and an overnight hospital stay. During midfoot realignment arthrodesis, an incision is made in the foot and screws and plates are inserted to stabilize the bones and joints. Bone and cartilage fragments are removed, the wound is flushed, and the incision is sutured.
Following this surgery, a non-weight-bearing cast is required for about 3 months, followed by a weight-bearing cast for another month or so. Custom-made shoes and inserts (orthotics) are then required for walking.
Hindfoot and ankle realignment arthrodesis is performed when the patient is unable to walk and braces are no longer helpful. This procedure requires general anesthesia and at least an overnight stay in the hospital. During hindfoot and ankle realignment arthrodesis, an incision is made in the foot and screws and plates are inserted to stabilize the bones. Bone and cartilage fragments are removed, the wound is flushed, and the incision is sutured.
After this procedure, a non-weight-bearing cast is worn for about 3 months, and then a special brace to protect the arch is worn for 2 or 3 months. Patients often require a custom-made brace to walk following this surgery. With the use of a brace, the foot must be closely monitored because the patient may not feel pressure from a poor fit.