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THIS INFORMATION IS FOR HEALTHCARE PROFESSIONALS ONLY

Up to 80% of diabetic patients
are more likely to die
within 5 years of having
a limb amputation

  • Diabetes is the seventh leading cause of death in the USA
  • 0.3% to 7.5% of diabetic patients may develop a Charcot Neuroarthropathy
  • Almost 100,000 patients with diabetes will suffer an amputation
    each year in the USA
  • Worldwide 85% of leg amputations is a result of a diabetic foot ulcer
  • With Charcot Neuroarthropathy, a minor injury can lead to amputation
4 out of 5 limb amputations
can be prevented


Discover the indications for a surgical intervention
and what are the goals of surgery

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CHARCOT

DEFORMITY

ULCER

INFECTION

AMPUTATION

INACTIVITY

POSSIBLE PREMATURE DEATH

WHO ARE MORE LIKELY TO DEVELOP A CHARCOT NEUROARTHROPATHY?

Charcot patients are more likely to be men

Over 50 years as average

is the incidence rate of Charcot in patients with diabetes

Investigation for a correct diagnosis

Find out what are the methods and tools for a correct diagnosis of Charcot Neuroarthropathy

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b) for transmitting my data to third parties (namely to other Orthofix Group’s legal entities and/or to distributors engaged by them or by Orthofix directly), in order to enable them to send me their own marketing and promotional communications regarding Orthofix-branded products or services and/or new initiatives and events sponsored or organized by them or on their behalf.

What is Charcot Foot and Ankle?

Charcot Neuroarthropathy is a condition causing weakening of the bones and ligaments in the foot and the ankle that can occur in people who have significant nerve damage (neuropathy), most often related to diabetes.

The bones are weakened enough to fracture and/or dislocate and, with continued walking and weight bearing, the foot eventually changes shape.

As the disorder progresses, the joints collapse and the foot takes on an abnormal rocker bottom shape.

Limb can be saved,
thus saving a life

Timely diagnosis facilitates treatment and decreases long-term disability. The best safeguard is a high index of suspicion, especially in any diabetic patient with a swollen, red, warm foot in the presence of somatic or autonomic neuropathy.

Charcot foot and ankle can be managed with off-loading, braces or casting and surgery. If untreated, this destructive process leads to deformity, ulceration, infection, and ultimately – at worst – to amputation.

In presence of severe deformities – that cannot be treated in a brace – osteotomy, fixation and temporary off-loading can help to correct deformities.

Can the external fixation be an option?
Watch out three successful clinical cases
of Charcot treated with off-loading
through circular external fixation


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I have read and understood the Privacy Policy above and, therefore, I hereby consent to the processing of my personal data by Orthofix S.r.l.: a) for sending me marketing and promotional communications regarding Orthofix-branded products or services, or new initiatives and events sponsored or organized by or on behalf of the Controller;

b) for transmitting my data to third parties (namely to other Orthofix Group’s legal entities and/or to distributors engaged by them or by Orthofix directly), in order to enable them to send me their own marketing and promotional communications regarding Orthofix-branded products or services and/or new initiatives and events sponsored or organized by them or on their behalf.

AWARENESS IS KEY

What to ask your patient

  • Do you have a history of diabetes?
  • If yes, do you regularly check your glycemic levels?
  • Do you have a history of diabetic foot pathology?
  • Did you have prior angioplasty, stent or leg bypass surgery?
  • Do you feel any leg or foot pain and discomfort at rest?
  • Have you noticed a loss of your leg sensation?
  • Has your foot lost the ability to feel pain, heat and cold?
  • Do you smoke?
  • Do you drink alcohol?

What to look for

  • Warm, swollen, red foot and/or ankle (Active Charcot)
  • Higher temperature of 2°C or 4°F of one foot compared with the contralateral one
  • Interdigital maceration
  • Skin lesions, ulcers and open wounds
  • Hypertrophic calluses or corns
  • Discolored, ingrown nails
  • Crepitant cellulitis
  • Fungal infection
  • Bone deformities
  • Loss of foot sensitivity
  • Limited range of joints motion
  • Absence of Achilles Tendon reflex
  • Vascular compromise, with sudden absence of dorsalis pedis and posterior tibial pulses
  • Peripheral arterial disease
  • Diabetic gangrene and necrosis
  • Previous amputation

What to teach your patient

  • Have a preventive foot evaluation every year
  • Examine foot skin and nails daily and have a regular expert podiatric care
  • Report any swelling, redness, lesions and skin discoloration
  • Choose appropriate footwear
  • Do not walk barefoot
  • Replace orthotic shoes every year: they should fit perfectly
  • Report absence of pain when it should be felt (e.g. touching hot water)
  • Stop or reduce smoking
  • Reduce alcohol

Proper surgical procedure is the responsibility of the medical professional. This information is furnished as an informative guideline. Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience.

WHEN IS IT TIME FOR A SPECIALIST?

Priority

Indications

Timeline

Follow-up

PRIORITY

Indications

  • Open wounds and deep ulcers
  • Pain at rest
  • Active Charcot Foot deformity
    (red, hot, swollen)
  • Vascular compromise

Timeline

  • Urgent/immediate referral
  • Patient needs interdisciplinary care management, off-loading with total contact cast devices and/or surgery, diabetic orthopedic footwear

Follow-up

  • According to specialist decision

PRIORITY

Indications

  • No sensitivity
  • Ulcers
  • Chronic vascular venous insufficiency
  • Previous lower limb amputation
    related to diabetes

Timeline

  • Immediate/first available referral
  • Patient needs diabetic orthopedic footwear, preventative off-loading and appropriate therapy

Follow-up

  • Every 1-2 months

PRIORITY

Indications

  • Insufficient sensitivity
  • No ulcers
  • Foot deformity
  • Posterior tibial pulse diminished or absent
  • Foot swelling, aedema

Timeline

  • Referral within 3 weeks
  • Patient needs prescriptive footwear, preventative off-loading and appropriate therapy

Follow-up

  • Every 2-3 months

PRIORITY

Indications

  • Insufficient sensitivity
  • No ulcers
  • No foot deformity

Timeline

  • Referral within 1 months
  • Patient needs prescriptive footwear and preventive foot health behaviors education

Follow-up

  • Every 4-6 months

PRIORITY

Indications

  • Satisfactory sensitivity
  • No ulcers
  • Possible foot deformity
  • No peripheral artery disease

Timeline

  • Referral within 3 months
  • Patient needs foot care and preventive foot health behaviors education

Follow-up

  • Once a year

Proper surgical procedure is the responsibility of the medical professional. This information is furnished as an informative guideline. Each surgeon must evaluate the appropriateness of a technique based on his or her personal medical credentials and experience.

ABOUT ORTHOFIX

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Download the Practical Guideline about The Surgical Management of Neuropathic (Charcot) Foot and Ankle Please read our Privacy Policy before submitting this form

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a) for sending me marketing and promotional communications regarding Orthofix-branded products or services, or new initiatives and events sponsored or organized by or on behalf of the Controller;

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