Shoes and Orthotic Devices for Charcot Foot Care  - Focusing on the Association with Diabetes -

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  • TAKESHIMA Kenichiro
    Department of Orthopaedic Surgery, International University of Health and Welfare（IUHW）Ichikawa Hospital Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare（IUHW）
  • WASEDA Akeo
    Department of Rehabilitation, Ogikubo Hospital

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Other Title
  • Charcot foot の足をケアする靴と装具～糖尿病との関連を中心に～
  • Charcot foot ノ アシ オ ケア スル クツ ト ソウグ : トウニョウビョウ ト ノ カンレン オ チュウシン ニ

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<p>In Charcot foot, joint dislocation and fracture not involving infection frequently occur due to sensory disorders associated with diabetes or other conditions. In the absence of subjective symptoms, the foot or ankle joint becomes unstable, leading to foot deformities such as rocker bottom foot. Delays in the initiation of treatment may result in irreversible osseous changes, and the development of calluses or ulcers markedly increases the risk of below-knee amputation. Therefore, appropriate diagnosis and early treatment provided by orthopedic surgeons are essential. When a diagnosis is established in the early stage of the disease, and treatment is provided effectively using total contact casts and orthotic shoes, favorable outcomes are likely to be achieved, but it should also be noted that osseous changes may progress in response to conservative treatment, requiring surgical therapy. When performing surgery in such cases, it is important to maintain correct foot and ankle joint alignments to the greatest possible extent in order to enable the foot sole to contact the ground. Considering the high incidence of complications, represented by pseudarthrosis and infection, and long-term treatment needed in many cases, not only education for patients and their families, but also collaboration among multiple professionals, including nurses, physical therapists, and prosthetists/orthotists, is indispensable in Charcot foot care.</p>

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