Charcot’s foot (or ‘Charcot arthropathy’) is often said to be a rare condition. However it is surprising how many people are harmed by failures to recognise the condition. Sadly those failures can be catastrophic. In one recent case a woman had to have her lower leg amputated. In another a young woman found herself reliant on a wheelchair for life. The condition may be uncommon but doctors treating patients with diabetes should know all about it.
One of the effects of diabetes is that people’s feet are at risk of injury. Diabetes reduces the blood supply to the foot. This means that its nerves do not always function well and patients do not necessarily realise they have been injured. It also means that injuries are slower to heal. Patients may be walking on a damaged foot without realising it. The bones can gradually collapse, leading to permanent disability and in some cases amputations.
The first symptoms are usually swelling, redness and warmth in the foot. The foot can then become out of shape. The arch at the bottom of the foot can collapse. This is often called a ‘rocker-bottom foot’.
Charcot’s foot goes through 3 stages.
Stage 1 – acute. There is redness, swelling and warmth. X-rays may show swelling of the soft tissues and some changes to the bones.
Stage 2 – sub-acute. There is less redness, swelling and warmth. X-rays show some healing of the bones although they may be out of place.
Stage 3 – chronic (or ‘reconstruction-consolidation’). The bones may or may not have healed but the foot is deformed.
It is very important that doctors recognise the condition or at least realise that the patient should be seen urgently by a specialist. NICE guidelines require GPs who see diabetic patients with foot problems to refer them urgently to a specialist diabetic foot clinic.
The condition is treated by immobilising the foot in plaster and making sure patients do not bear weight on the foot. Sometimes they may need surgery to treat a fracture. They will then need good foot care and surveillance for life.
GPs, orthopaedic surgeons, general physicians and specialists in managing diabetes should all know about Charcot’s foot. Sadly in several of cases they have failed to do so. Getting it wrong can be disastrous.
Diabetes is on the increase. It is the fasting growing threat to health in the UK. The numbers of people with the condition has doubled in 20 years. 3 million people now have the condition. That is around 6% of the population. It is thought that figure will increase to 5 million. Charcot’s foot is therefore likely to become an increasingly common problem. Doctors will see more cases. It is therefore crucial that they recognise it to avoid more patients becoming seriously disabled after avoidable delays in diagnosis.
Enable Law works closely with Diabetes UK in supporting campaigns for better footcare for people with diabetes. It also works with Abdo Haider, prosthetist, and The London Prosthetics Centre. Its specialist solicitors have experience of claims for people who have suffered amputations as a result of medical negligence.
If you think you may have suffered negligence as part of diabetic treatment, speak to one of our team today on 0800 044 4884.