02 May Metatarsal Surgery for Charcot Foot
An injury or deformity involving any one of the five metatarsal (long) bones of the feet can cause debilitating pain, difficulties with walking, and other associated symptoms. Conditions that affect these bones can be managed conservatively, depending on the pathology, but there are times when surgical treatment of the metatarsals is indicated. This includes conditions where the conservative measures are no longer effective or in severe cases where surgical intervention is the first-line management.
Indications for Metatarsal Surgery
The following conditions are those where metatarsal surgery is indicated:
- Callus formation at the bottom or ball of the foot.
- Bunion deformities.
- Where complications occur as a result of chronic conditions such as diabetes, arthritis, and other autoimmune conditions.
- Fractures of the metatarsal bones.
One such condition that arises as a complication of diabetes is Charcot’s foot. This develops as a result of diabetes causing a peripheral neuropathy where the nerve supply to the foot has a compromised blood flow to it leading to decreased sensation in the limbs. Patients can then no longer feel when they sustain any injuries to the foot and continue using the limb thereby worsening the situation.
When the affected patient keeps using the injured foot, the shape of the limb eventually changes. As the condition progresses, the joints in the foot collapse and the limb takes on an abnormal shape. This can be a potentially life-threatening condition because it may result in the patient having their foot amputated.
Symptoms and signs of Charcot’s foot may include:
- Swelling of the affected area.
- Increased redness and warmth of the swollen part of the foot.
- Complaints of pain or soreness.
- Tender to touch.
Non-surgical management of the condition may include:
- Immobilization of the foot – because the affected foot and ankle are very fragile, they must be protected in order for the weakened joints and bones to repair themselves. The patient is suggested to not bear weight on the foot to prevent further collapse and this is aided by applying a cast or a removable brace or boot to the affected limb.
- Modification of the patient’s activity – this may need to be done to prevent repetitive trauma to the affected foot as well as the normal foot as this can be affected at a later stage.
- Custom shoe inserts – affected patients may need to have special inserts placed in their shoes after the bones in the foot have healed in order for them to return to their normal activities.
Surgery may have to be performed in situations where:
- An infection has set into the bone and metatarsal surgery will have to be performed to remove any infected tissue so that the sepsis doesn’t spread.
- If the conservative measures have failed then surgery may have to be performed to fuse the bones into a more acceptable position.
Oasis Foot and Ankle Center
The healthcare professionals at Oasis Foot and Ankle Center are specially trained to deal with conditions such as Charcot’s foot by managing the condition through conservative and surgical measures.