Peripheral Neuropathy Surgery and Charcot Foot Surgery

Peripheral Neuropathy Surgery and Charcot Foot Surgery

Peripheral neuropathy and Charcot Foot go hand in hand. Every patient who suffers from Charcot foot also has peripheral neuropathy, but not every peripheral neuropathy patient will develop Charcot foot. Peripheral neuropathy presents with complaints of numbness, pain or tingling in the feet and legs.

Charcot foot presents as a red, hot, and swollen foot with multiple fractures and sometimes dislocations but very little pain. Treatment for foot neuropathy varies from better Diabetic control to medications or supplements, and physical therapy to surgery. Charcot foot treatment may require only immobilization and non-weight bearing or custom foot wear. Complicated, extensive reconstructive limb salvage surgery may also be an option for more severe cases.

Foot Neuropathy Treatment

Treatment for foot neuropathy is aimed at relieving pain and restoring sensation which leads to improved function and quality of life. If the cause of the foot neuropathy is known, then treating the underlying cause may provide relief. Unfortunately, 33% of the time we do not know what causes the neuropathy and must treat only the symptoms. However, in many cases, there is found to be nerve entrapment related to the foot neuropathy which is responsible for the pain or numbness. This is determined primarily by physical exam but can be confirmed but not ruled out with nerve conduction studies.  In these cases, if the patient is a good surgical candidate, nerve surgery on the foot, or peripheral neuropathy surgery, may relieve pain and restore normal sensation.

In peripheral neuropathy surgery, the nerves in the foot and leg are decompressed or freed of surrounding pressure which in turn results in less pain and improved sensation. Nerve surgeries on the foot are out-patient procedures and recovery is relatively quick. Success rates of this type of foot neuropathy treatment, using nerve surgery on the foot and leg, have been reported at 90% for relief of pain and 70% for return of normal sensation.

Charcot Foot Surgery

Charcot Foot or Neurogenic Osteoarthropathy is an extremely complicated and potentially catastrophic condition effecting the foot and ankle which may result in amputation. In order for a patient to develop Charcot Foot, they must first have foot neuropathy. Treatment of Charcot foot is aimed at saving the leg by restoring stability to the foot and ankle so that the patient can bear weight and walk.

Foot neuropathy

In some cases, if the condition is diagnosed and treated early, conservative treatment is an option for the Charcot foot using casts and non-weight bearing until the foot heals. However, in many cases, the foot becomes deformed and unstable and Charcot foot surgery is required.

Confusingly, Charcot foot surgery, in most cases, does not include nerve surgery on the foot. Instead, surgery on the Charcot foot and ankle involves repair of fractures and multiple joint fusions to stabilize the foot and ankle on the leg. Charcot foot surgery is a very involved, complex surgery with a relatively high failure rate while foot neuropathy treatment or nerve surgery on the foot is much more simple with a shorter recovery. Charcot foot surgery often requir2es internal and external fixation of bones while nerve surgery only involves soft tissue and stitches. Both can be very effective if done properly in the appropriate patient.

The surgeons at Certified Foot and Ankle Specialists are experts at treating peripheral neuropathy and Charcot foot, either conservatively or with surgery if needed.

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