FOOT AND ANKLE DEFORMITIES

There are a number of common and less common foot and ankle deformities that David Larson, DPM, has experience and specialized training in treating, including Charcot foot, Cavus foot and hammertoes, among others. After an exam, Dr. Larson can determine your risk and make treatment recommendations. To make an appointment, call the office in Mesa or Phoenix, Arizona, or request an appointment online today. 

What are Foot & Ankle Deformities?

There are a number of common and less common foot and ankle deformities that Dr. Larson has both experience and specialization in treating; this includes but is not limited to Charcot foot, Cavus foot and hammertoes, among others.

What is Charcot Foot? 

Charcot of the foot and ankle, also called Charcot Neuroarthropathy, is a condition that causes weakening of the bones enough to fracture, which can occur in people with significant nerve damage (neuropathy). Charcot of the foot and ankle is a very serious condition as it may lead to severe deformity, disability, or even worse, amputation. 

Those with diabetes are at higher risk for developing Charcot foot. If left untreated and continued weight bearing, the foot eventually changes shape. The foot and ankle become at high risk for skin breakdown or ulceration, which can lead to infections. Having Charcot foot in one limb puts a person at increased risk of developing it in the other.

What are the Treatments for Charcot Foot? 

Non-Surgical Treatment Options for Charcot Foot

• Immobilization – A patient may need to wear a cast, removable boot, or brace, in addition to using a wheelchair or crutches. This allows the fragile bones in the foot and ankle to heal.
• Custom shoes and bracing – Custom shoe inserts may be needed after the bones heal to prevent Charcot foot from reoccurring. Custom braces may be needed to resume normal function in severe cases.
• Activity modification – To prevent reoccurrence, a patient may need to reduce their activity level and make lifestyle modifications.

Surgical Treatment for Charcot Foot 

For serious deformity resulting from Charcot foot, surgery may be necessary.

• Exostectomy – If a bony prominence is present (with or without ulcerations), removal of the prominence may be necessary.
• Reconstruction – In situations where the foot is unbraceable or in the case of chronic, non-healing ulcers, reconstruction may be necessary, Charcot reconstruction is performed. It is critical that this procedure be performed by a surgeon specifically trained in Charcot reconstruction with training in external fixation.
• Amputation – Reserved for the most severe cases only when the foot is unsalvageable due to abscesses, infection or extensive bone loss.

What is Cavus Foot? 

Cavus foot, or high foot arch, subtle cavus foot, or pes cavus, means that the arch of your foot is raised higher than normal, even while standing. This condition is the opposite of flat feet and is less common, but often more painful. Many people with this condition will experience pain in the top and middle areas of their foot when standing or walking. Finding a good fit with shoes can be challenging. People with cavus foot are also more at risk for frequent ankle sprains due to the imbalance of the foot that cause the ankle to roll toward the outside.

What is the Treatment for Cavus Foot? 

Conservative care is often highly successful in the treatment of cavus foot. The first course is an orthotic to help balance the foot and ankle instability. In severe cases of cavus that have not responded to conservative measures, surgical intervention, or cavus foot reconstruction, may be necessary. 

The surgical procedures to correct cavus foot depends on the patient's foot and ankle alignment and related problems. Most common, the foot is realigned by cutting and repositioning the bones, a procedure known as osteotomies. Repairing fractures, tightening ligaments and transferring tendons may also be necessary. The goal with surgery is to restructure the foot to evenly distributes weight along both inside and outside edges. Surgical techniques to repair cavus foot may include: soft-tissue surgery, dorsiflexion osteotomy of the first metatarsal, calcaneal (heel bone) osteotomy, tendon transfers, bony surgery, fusion and toe surgery to correct clawed toes common in cavus foot.

What are Hammertoe and Mallet Toe?

Hammertoe and mallet toe are foot deformities that occur due to an imbalance in the muscles, tendons or ligaments that normally hold the toe straight. Contributing factors include the type of shoes you wear, foot structure, trauma and certain disease processes that contribute to the development of these deformities. In hammertoe, there is an abnormal bend in the middle joint of a toe. In mallet toe, the joint nearest the toenail is affected. Both usually occur in your second, third and fourth toes.

How are Hammertoe and Mallet Toe Treated? 

Relieving the pain and pressure of hammertoe and mallet toe may be as simple as changing your footwear and wearing shoe inserts. More severe cases of hammertoe or mallet toe may require surgery. Specific exercises can also help to stretch and strengthen your toe muscles. When conservative treatments fail, surgery may be needed to release the tendon that is preventing the toe from laying flat. Occasionally, there is a piece of bone that may also need to be removed to correct the deformity. 

To learn more about Foot and Ankle Deformities, make an appointment at the practice of David Larson, DPM, today. Call the nearest office to speak with a staff member or request an appointment online.