How to Improve the Outcome of Charcot Foot: Results of Five Years Follow-up Prospective Study

Abstract Background: Egypt is among the world's top 10 countries in terms of the highest number of people with diabetes. Delayed presentation and lack of appropriate foot care could account for different outcomes of Charcot-foot. Aim of Study: Study the impact of nullification of the suggested risk factors on the outcome of Charcot-foot. Patients and Methods: We did a prospective analysis of the impact of compliance with the nullified suggested risk factors on both feet as compliance with 1- Wearing the removable-cast-walkers, 2- The regular follow-up visits, 3- Nullified leg-length discrepancy induced by the removable-cast-walker, and 4- Slowing of the gait speed (24 steps ±3/min). 43 patients presented ³5 years ago with unilateral chronic Charcot and normalcontralateral foot were included and subdivided into (Group-A) compliant with all nullified risk factors and (Group-B) non-compliant with ³1 of the risk factors, of matched age, sex, BMI, HbA1c and diabetes duration. Both feet are then examined for any complications that happened since January/2010 till February/2016. Results: Our results showed statistically significant dif-ference regarding the complications happened in the Charcot-foot, 11.1% (n=2) vs. 44% (n=11) and in the contralateral foot, 16.7% (n=3) vs. 48% (n=12) in group A vs group B respectively. Adherence to nullification of the suggested risk factors decreases the occurrence of complications by >6 folds in the Charcot-foot (odds ratio 6.3, p=0.03) and >4 folds in the contralateral foot (odds ratio 4.6, p=0.04). Conclusion: Nullification of leg-length-discrepancy, slowing of the gait speed, compliance with the removable-cast-walker and regular follow-up visits greatly improved the outcome of Charcot foot in our foot clinic.