Diabetic Foot Care
Foot problems are a common complication of diabetes. Diabetes can cause nerve damage, which leads to a loss of sensation in the feet. This loss of sensation can progress to the point that a person can no longer feel when the skin on the feet is irritated or punctured. The skin can become dry and cracked, allowing bacteria in. Something as small as a blister can progress to an infection very quickly.
Diabetes also causes poor circulation, which can weaken the bones in the feet, making them more susceptible to fractures. If nerve damage is also present, a person may not even realize that he or she has a fracture and may continue to walk on the injured foot. This can lead to more severe fractures or dislocations. Eventually, this can cause deformity of the foot, a condition called Charcot arthropathy.
Symptoms of Charcot Arthropathy
Because nerve damage is present, patients usually do not experience pain. Swelling is an early sign of Charcot, even if there is no obvious injury to the foot. There may also be some redness for the foot early on. An X-ray will reveal if there are any fractures or changes in the bone.
Early detection is critical to prevent serious problems with the feet. If you have diabetes and have nerve damage, examine your feet every day, looking for any swelling, wounds, bruising, redness, scratches, warmth, blisters, or nail problems. These signs could indicate an infection or lead to more serious problems if untreated.
Treatment of Diabetic Foot
Treatment for diabetic foot is focused on healing any broken bones and prevent further damage to the foot. The early stages of Charcot arthropathy can be treated with nonsurgical methods, but if there is severe foot deformity, surgery may be needed.
If there is a fracture, a cast or cast boot may be used to protect the foot and ankle as the bones heal. Crutches or a wheelchair are often needed to keep weight off the foot during the healing process. A customized shoe or walking boot may also be recommended after the foot has healed to protect the foot and decrease the risk of ulcers.
If the patient has a high risk of ulcers due to foot deformity or there is an unstable fracture or dislocation in the foot, surgery may be needed. The surgical procedure will depend on the type and severity of the foot deformity.
If the deformity is mild and caused by tightness at the back of the heel, surgical lengthening of the Achilles tendon may be helpful. The Achilles tendon runs down the back of the leg and attaches to the back of the heel. Lengthening this tendon decreases on the midfoot and front of the foot.
If the patient has a stable bone deformity, the protruding portion of the bone may be removed. If the deformity is unstable, the bones may need to be repositioned and fused together using plates and screws. After this procedure, patients generally need to avoid putting weight on the foot for at least 3 months while it heals.
If the deformity is in the ankle, a fusion of the ankle and the joint below the ankle may be needed to hold the foot straight. However, due to the poor quality of the bone and surrounding tissues, there is a risk that the ankle may not heal properly. The risk of infection is very high in this case, and if the procedure is unsuccessful, amputation may be necessary to salvage the limb.
After surgery, it is very important to follow all instructions given to you by your doctor to allow for the best possible outcome.
Diabetic Foot Care in Houston, TX
At Spring Branch Podiatry, our podiatrists are skilled in advanced foot and ankle techniques, including diabetic foot care and diabetic limb salvage. If you would like to learn more about our diabetic foot care options or schedule an appointment, please contact our office at (713) 461-1010.