What is Charcot ankle?

Charcot foot, or Charcot’s arthropathy, is defined as a neuropathy induced condition which results in the weakening of the ankle joint, and ultimately the flattening of the feet. With this condition patients lose some of the protective sensations in the foot, that then leads to destruction of foot, ankle joints and surrounding bone. In some cases, patients can not feel when the foot has been injured or even punctured and this can lead to ulceration of the skin that does not heal on its own.

Charcot foot can be very severe for patients who do not seek treatment or proper medical management. When the bones, joints and soft tissues of the foot and ankle become weak, it can cause bones to break and deform the shape of the foot, leading to disability. Prevention of further destruction and deformity of the foot in the acute phase is the primary goal of treatment.


There are many causes of a Charcot Foot, but the primary source is dysfunction of the nerves in the foot and ankle. Most often, this condition is a complication of diabetic neuropathy, which can affect both people with Type 1 or Type 2 diabetes. Diabetic neuropathy usually begins in patients who have been managing diabetes for a long time.

Classification is important because it helps direct treatment.

Eichenholtz classification

  • Stage 0 = joint swelling, radiographs look normal
  • Stage 1 = joint swelling, redness, radiographs show that bones fragmenting (breaking) and can include joint dislocations
  • Stage 2= Joint swelling decreases and radiographs start to show healing of the bone
  • Stage 3 = No joint edema and radiographs looked healed but the foot maybe stuck in a deformed position


  • Foot suddenly becomes very swollen, red and warm to touch (acute charcot)
  • Patient experiences pain but can recall no history of trauma
  • Slow, or no recovery to an injury (i.e swelling does not go away)
  • Joint is hot, red and looks infected
  • Foot has visually lost its shape or is now deformed
  • Change in foot colour
  • Joint subluxation or dislocation


Understanding the underlying causes and properly diagnosing your condition is the first step to treatment. We then provide a holistic approach to helping patients and their families through their surgical journey. Properly supporting you and/or your child, while educating you on the details helps us ensure the most successful outcomes possible. Our hands on, team approach makes patients feel supported throughout the whole treatment process.

To learn more about your condition and receive a diagnosis, schedule a virtual consultation with one of our experienced orthopedic doctors. During this consultation, all your questions will be answered as our specialists guide you through the evaluation process.

Conservative treatment

  • Braces
  • Orthopaedic footwear
  • Offloading devices
  • Total contact casting

Conservative treatment is recommended for stages 0-3, when possible. If in the healed stage 3, the foot is deformed to the point that shoe wear is not possible or it causes ulceration of the skin, then surgical intervention is recommended.

Surgical treatment


Acute Deformity Correction


Bone transport and other techniques


Charcot foot treatment


Gradual Deformity Correction with External Fixation

Case study

76 year old lady with ankle fracture
46 year old man with deformity of the foot and ankle with charcot


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Highly specialized expert care at CLLC

At the Canadian Limb Lengthening Centre we offer complex deformity correction and limb lengthening surgeries performed by experienced surgeons with the most up to date technologies. When it comes to your care, and treatment of deformity and limb length discrepancy, our surgeons have extensive training and experience.