Table 3

Treatment of Charcot arthropathy at a tertiary care specialty foot clinic*

VariableNo. of feet (%)†
Clinical course
 Nonoperative treatment, resolved55 (70)
 Nonoperative treatment and surgery20 (26)
 Nonoperative treatment, lost to follow-up3 (4)
Nonoperative treatment‡§
 Total contact cast60 (77)
 Removable walker brace17 (22)
 CROW1 (1)
Duration of nonoperative treatment, mo, mean ± SD**
 Until resolution
  All feet (55 feet)6 ± 5
  Total contact cast (40 feet)5 ± 3
  Removable walker brace (15 feet)8 ± 7
 Until surgery
  All surgery including amputation (20 feet)5 ± 5
  Amputation (6 feet)3 ± 2
Complications during nonoperative treatment
 Superficial skin irritation5 (6)
 Noninfected ulcer5 (6)
 Infected ulcer5 (6)
 None63 (81)
Outcome of ulcers present at initial evaluation (23 feet)
 Resolved with nonoperative treatment††17 (74)
 Required surgery4 (17)
 Lost to follow-up2 (9)
Surgery
 Indications for surgery
  Infection11 (14)
  Deformity causing recurrent ulcer9 (12)
 Procedures
  Exostectomy alone8 (10)
  Exostectomy with irrigation and débridement5 (6)
  Lower limb amputation6 (8)
  Arthrodesis1 (1)
  Total20 (26)

  • CROW = Charcot Restraint Orthotic Walker; SD = standard deviation.

  • ↵* n = 78 feet in 76 patients.

  • ↵† Unless indicated otherwise.

  • ↵‡ No feet had more than 1 type of nonoperative treatment documented.

  • ↵§ Urban residence: 44 feet in 43 patients: total contact cast, 35 feet (80%); removable walker brace, 9 feet (20%).

  • ↵ Rural residence: 34 feet in 33 patients: total contact cast, 25 feet (74%); removable walker brace, 8 feet (24%); CROW, 1 foot (3%).

  • ↵** Duration from initial evaluation in the foot clinic until resolution or surgery; total = 75 feet because 3 feet were lost to follow-up.

  • ↵†† In these 17 feet, time from initial presentation to healed ulcer with nonoperative treatment, 5 ± 5 months.