Conservative treatment of charcot neuroarthropathy

Abstract

A multidisciplinary approach is the key to Charcot foot management. The total contact cast (TCC) remains the gold standard treatment of active Charcot neuropathic osteoarthopathy (CN). However, outcomes are better if treatment is started as soon as possible after the onset of clinical symptoms. Immobilization can be achieved with either a non-removable or removable device, although shorter periods of immobilization are needed if non-removable devices and non-weight bearing are employed. If deformity progresses despite treatment, there is a role for surgery to stabilize the foot and prevent progression. Whilst our understanding grows of the pathological process, there is little evidence to confirm the usefulness of available pharmacologic therapies to promote the healing of Charcot foot and casting remains the fundamental treatment.