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How to Treat Charcot Neuropathy by Dr. Patrick DeHeer, DPM

How to Treat Charcot Neuropathy by Dr. Patrick DeHeer, DPM


Charcot Neuropathy, also known as Charcot arthropathy or Charcot foot and ankle, is a syndrome in patients who have peripheral neuropathy, or loss of sensation, in the foot and ankle. Patients may experience fractures and dislocations of bones and joints with minimal or no known trauma. Initially, there may be swelling, redness, and increased warmth of the foot and ankle. Later, when fractures and dislocations occur, there may be severe deformities of the foot and ankle, including collapse of the midfoot arch (often called rocker bottom foot) or instability of the ankle and hindfoot. The Acute TayCo External Ankle Brace provides stability without limiting function to patients recovering from acute ankle injuries. It fits over the user’s footwear, providing comfort and protection against soft tissue damage. The brace fully restricts inversion and eversion of the ankle with options for immobilization and range of motion (ROM) for plantarflexion and dorsiflexion.

Treatment Protocol

According to the Modified Eichenholtz Classification for Charcot Neuropathy Stages 0, I, and II, the preferred treatment consists of decreased activity (non-weight bearing, preferably) and off-loading via total contact casting or cast brace until collation of deformity occurs (possibly up to 12 months).


This may not be practical for extended time periods and a TayCo External Ankle Brace, combined with diabetic foot orthosis and diabetic shoe, can be an alternative for these stages. Stage III deformities without severe structural changes can be treated long-term with a TayCo External Ankle Brace combined with diabetic foot orthosis and diabetic shoe if injury is more midfoot, Dr. DeHeer typically prescribes the ROM TayCo Brace. Choose a Custom or Acute brace based on severity of deformities. If the deformities are extreme, a cast of the ankle may be required. If injury is more hindfoot, Dr. DeHeer will immobilize the ankle with a fixed TayCo Brace. The Tayco External Ankle Brace provides an excellent ankle foot orthosis (AFO) option for patients requiring ankle and foot stabilization or immobilization that attaches to a shoe, instead of squeezing into a shoe. Many AFOs are challenging to fit into the limited space within a shoe. By attaching to the shoe externally, the TayCo Brace reduces soft tissue complications and is an effective, user-friendly device. Additionally, the TayCo Brace allows for the use of a custom or accommodative orthotic. With the TayCo External Ankle Brace, patients experience earlier return to function, better compliance, and better satisfaction relative to competitive products. Patient outcomes also improved, mainly due to compliance. The TayCo External Ankle Brace is also a good non-surgical option, or a conservative option before treatment.

- By Dr. Patrick DeHeer, DPM Upperline Health Indiana, Consulting Physician for the Indiana Pacers Dr. DeHeer earned a doctor of podiatric medicine degree from the Dr. William M. Scholl College of Podiatric Medicine in Chicago, and completed his residency in podiatric surgery at Winona Memorial Hospital in Indianapolis and a fellowship in foot and ankle arthroscopy under one of the most innovative and well-known podiatrists in Indianapolis, Richard O. Lundeen, DPM. Dr. DeHeer is a leading expert and international speaker for modern podiatry care.

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