Charcot Neuro-arthropathy

Charcot foot is a destructive complication of diabetic neuropathy in which fractures and joint dislocations occur without pain.

Diagnosis relies on clinical staging (Eichenholtz), infrared skin-temperature differentials and weight-bearing X-ray or CT to map bony collapse.

Symptoms evolve from a warm, swollen, “puffy” foot to mid-foot sag giving the classic rocker-bottom deformity; the skin may ulcerate over bony prominences.

Treatment begins with strict immobilization in a total-contact cast and optimization of glucose, calcium and vitamin D. When the foot reaches the consolidated stage, Dr Srinivas performs corrective osteotomies, internal or hybrid external fixation, and prescribes custom orthoses to restore a plantigrade, shoe-able foot and prevent ulcer recurrence.