Rare Diabetes Foot Complication Becoming More Common

Few people with diabetes know about the limb-threatening foot condition, or its warning signs

As diabetes rates soar nationwide, a rare diabetic foot complication is becoming more prevelant. This condition is called Charcot foot (pronounced SHAR-co). This condition involves a sudden softening of the foot’s bones which can trigger an avalanche of problems, including joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation and even death.

As the foot’s structure collapses, the bottom of the foot can become convex, bulging like the hull of a ship. But diabeteic patients frequently do not feel any pain because they have severe nerve damage in their lower extremities and do not feel these changes occurring.

Every person with diabetes should know the Charcot foot warning signs: A red, hot, swollen foot or ankle. Several other dangerous conditions, such as deep vein thrombosis and acute infections, share these symptoms. A red, hot, swollen foot or ankle requires emergency medical care.

The American College of Foot and Ankle Surgeons (ACFAS) estimates less than one percent of people with diabetes develop Charcot foot. But nationwide, the College’s 6,000 members say they’re noticing more Charcot cases as more Americans develop diabetes.

Charcot cannot be reversed, but its destructive effects can be stopped if the condition is detected early. People with diabetes play a vital role in preventing Charcot foot and its complications. Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. People with diabetes should also inspect both of their feet every day, and get regular check-ups from a foot and ankle surgeon.

For more information on Charcot foot and other diabetic foot conditions, visit the ACFAS consumer Web site, FootHealthFacts.org or contact my office at 440-946-5858.

Achilles Tendon Surgery Helps Prevent Diabetic Foot Ulcers

Diabetic patients frustrated by hard-to-heal, infection-prone ulcers on their feet could benefit from a common, minimally invasive surgical procedure to relieve tightness in their Achilles tendons.

The Achilles is the largest tendon in the human body, connecting the calf muscles to the heel bone. As we age, the tendon naturally tightens. However, diabetes exacerbates the process as increased blood sugar levels deposit glucose in the collagen of the tendon, greatly reducing its elasticity and making stretching almost impossible.

A tight Achilles inhibits ankle movement, forcing diabetic patients to place excessive pressure on the front of the foot. Pressure normally absorbed by the ankle has to go somewhere else and the forefoot gets most of it, heightening the risk for ulcer development underneath the toe joints.

Foot sores or ulcers are a common complication of diabetes. They result from sensation loss or neuropathy, which deprives diabetes patients of their ability to feel pressure or pain in the lower extremities. Therefore, even the slightest cut, blister or wound can develop into a diabetic foot ulcer. Such wounds can cause tissue and bone infections and can result in loss of a toe, a foot, a leg or even a life.

Published research has shown that surgery to lengthen the Achilles tendon in a diabetes patient can help prevent ulcer recurrence.

Lengthening occurs by making three small, pinpoint cuts to loosen and stretch the tendon. This helps restore ankle flexibility and relieves forefoot pressure. The procedure allows diabetes patients who keep their blood sugar under control to walk more normally and may lower their risk for redeveloping foot ulcers.

For further information about diabetic foot conditions, please contact our office for a consultation, 440-946-5858.

Old ankle sprains come back to haunt Baby Boomers

Many Boomers who have suffered ankle sprains in their younger years could be at risk for more serious damage as they age and try to stay active. It is estimated that one in four sports injuries involves the foot or ankle, and a majority of them occur from incomplete rehabilitation of an earlier injury.

Pain is not normal in the ankle, even if you're just getting back into shape.

Swelling is another symptom these previously-injured Boomers may experience. Both amateur and professional athletes often mis-understand how serious a sprain can be, and they rush back into action without taking time to rehabilitate the injury properly.

A sprain that happened years ago can leave residual weakness that isn’t noticed in normal daily activity, but subjecting the ankle to rigorous physical activity can further damage improperly healed ligaments, and cause persistent pain and swelling. Anyone hoping to regain past athletic fitness, it’s recommended that you have that old ankle injury checked out before becoming active once again.

Some sprains are severe enough to strain or tear the tendons on the outside of the ankle, called the peroneal tendons. Research shows that more than 85 percent of athletes who had surgery to repair a torn peroneal tendon were able to return to full sporting activity within three months after the procedure.

Peroneal tendon tears are an overlooked cause of lateral ankle pain. Although surgery for athletically active patients shouldn’t be taken lightly, surgical repair of the peroneal tendons is proving to be very successful in helping athletes with serious ankle problems return to full activity.

Persistent pain and tenderness after a sprain, especially if the individual felt a ‘pop’ on the outside of the ankle and couldn’t stand tiptoe, might be a warning sign that the tendon is torn or split. The injury is best diagnosed with an MRI exam.

If you or someone you know is in need of further information or an evaluation of the foot/ankle, plese call our office, 440-946-5858, we are here to help.