An overview of conservative treatment options for diabetic Charcot foot neuroarthropathy

Abstract

Conservative management of Charcot foot neuroarthropathy remains efficacious for certain clinical scenarios. Treatment of the patient should take into account the stage of the Charcot neuroarthopathy, site(s) of involvement, presence or absence of ulceration, presence or absence of infection, overall medical status, and level of compliance. The authors present an overview of evidence-based non-operative treatment for diabetic Charcot neuroarthropathy with an emphasis on the most recent developments in therapy.

Developing an evidence‐based clinical pathway for the assessment, diagnosis and management of acute Charcot Neuro‐Arthropathy: a systematic review

“…Again, these shoes should be fitted with custom-molded, full contact insoles to minimise load bearing and mobility during walking [8,20,78]. …”

“…The CROW has proven to be useful in maintaining foot and ankle alignment in the instable or surgical corrected CN foot [78], however, where aggressive conservative management has failed, surgical correction of the deformity should be considered [1]. …”

Conservative and surgical treatment of the chronic Charcot foot and ankle

“…Stage II (coalescence-subacute phase) is typically treated with protected weight bearing with a total contact cast or a molded total-contact polypropylene ankle-foot orthosis (7, 22). In Stage III (reconstruction-chronic), if the foot is plantigrade, the patient can use custom inlay shoes (21, 22, 25). If the patient has a non-plantigrade foot or recurrent history of ulcerations, debridement, exostectomy, correction, or fusion with internal fixation may be an option.…”

“…If the patient has a non-plantigrade foot or recurrent history of ulcerations, debridement, exostectomy, correction, or fusion with internal fixation may be an option. Also, in Stage III with the presence of osteomyelitis, recommended treatment is surgical debridement with or without staged reconstruction with internal or external fixation, or amputation (1, 2, 10, 17, 21, 22, 29). …”

Bone mineral density and markers of bone turnover and inflammation in diabetes patients with or without a Charcot foot: An 8.5-year prospective case-control study

“…It manifests as an aseptic inflammation of bones and joints in the feet leading to progressive degeneration of the bone structures, which can cause deformity and ulceration (2)(3)(4)(5) . The treatment consists of long-term off-loading, often accompanied by assisted wound healing and surgery (6,7) .…”