Charcot foot - definition, cause and therapy

About 0.5-1% (5,000 to 10,000) diabetics suffering from polyneuropathy have Charcot's foot. Charcot arthropathy, also known as diabetic neuropathic osteoarthropathy (DNOAP), is joint and bone destruction in the foot area, which increasingly occurs as part of diabetic nerve damage (neuropathy). The cause is pain that is not perceived or is not sufficiently perceived when the joints are strained and overloaded, which can ultimately lead to the destruction of the joints and bones. But how does the disease manifest itself and how can it be treated or prevented? Below you will find some information about this.

Causes of Charcot foot development

The exact cause of Charcot's foot has not yet been finally clarified. Two assumptions are currently being pursued that can promote the development of this disease: On the one hand, it is assumed that a large number of smaller bone fractures (microfractures) shatter the foot skeleton, on the other hand, increased blood circulation as the cause of bone softening is under discussion. Recent findings also indicate that disorders in bone cell metabolism promote the breakdown of bone mass and calcium in the bone tissue and thus promote the development of Charcot foot.

How is the disease manifested?

Due to the causes, there is instability in the affected area of ​​the foot, which can lead to a collapse in the arch of the foot and a flat foot. All joint areas of the foot can be affected. Even in the early stages of this development, the affected foot can be red and overheated. Foot ulcers (ulcers), e.g. due to pressure overload, can be signs of injuries and already represent a preliminary stage.

Who is at risk of Charcot foot and how can it be prevented?

This disease occurs particularly frequently in people who suffer from diabetes, since complications in the feet due to vascular and nerve damage and the associated lack of sensory disturbances often go unnoticed.

Other nerve diseases can also lead to sensory disturbances in the feet and thus trigger Charcot foot. Thus, not only people suffering from diabetes are affected by this disease.

It is important for people with reduced sensory disturbances to have regular, at least daily, check-ups on the affected areas and regular check-ups, e.g. by a podiatrist. If there are indications of pressure points or injuries, consult a doctor immediately.

How is Charcot foot treated?

Treatment for Charcot foot is determined based on the stage of the disease, the affected area of ​​the foot, and the extent of the inflamed process. In most cases, this consists of pressure relief and immobilization and can be supplemented by surgical interventions. To relieve pressure and promote stability, the affected foot is often immobilized in a special cast (total contact cast) or a 2-shell orthosis. An orthopedic made-to-measure shoe or insoles in the form of a diabetes-adapted footbed may then be necessary.

What is the purpose of measuring the temperature of the feet?  

Elevated temperature values ​​can indicate possible incipient inflammation, which can lead to complications in patients with diabetic foot syndrome, for example. In addition to daily foot checks, several studies have shown the positive effects of regular plantar temperature measurements.  

The studies mentioned below were not carried out with intelligent shoe inserts.  

The first indications of this came as early as 1975 in a study by Bergtholdt and Brand .  

The International Working Group on Diabetic Foot (IWGDF) led by Prof. Dr. Bus has already included regular foot temperature checks as a recommendation in its guidelines .  

Further studies indicate that over 70% (sometimes even over 90%) of foot complications were detected early through temperature measurements.  

How can the intelligent shoe inserts from osentec support?  

Advertisement:

The intelligent shoe inserts from osentec use tiny sensors to measure the temperature of the soles of the feet and detect differences from as little as 0.1°C. The associated app compares the recorded values ​​with each other and sends a message as soon as the temperature differences last longer than 48 hours. In this way, we support the initiation of measures at an early stage and thus a preventive reaction to possible ulcers and wounds.

We would be happy to advise you on the advantages of an accompanying measure using our intelligent shoe inserts. Visit our osentec website for more information on how the insoles work and how they can contribute to well-being. you can reach us at info@osentec.de and by telephone on 0395 3511 6213.