Protected Weight Bearing During Treatment of Acute Charcot Neuroarthropathy: A case series

The Foot and Ankle Online Journal 4 (7): 1 Standard of care in the treatment of acute Eichenholtz stage I Charcot neuroarthropathy includes complete non-weight bearing immobilized with total contact casting.This small case series of three patients focuses on patients with acute phase midfoot Charcot neuroarthropathy treated with non-casting immobilization therapy.All patients were male with a mean age of 48.7 (range 46-53) years.Patients were instructed to assume complete non-weight bearing during treatment.Due to financial restrictions, all patients reported fully weight bearing in the non-removable immobilization boot because of work related obligations.Immobilization therapy lasted a mean duration of 90.3 days (range 76 -133 days) and was discontinued once there was clinical resolution of inflammation and osseous stability.Serial radiographs revealed absence of deformity progression and eventual consolidation in all cases.All patients remained ulcer and callus free during immobilization therapy, without progression of a rocker-bottom deformity, while fully weight bearing and maintaining full-time manual labor employment.This preliminary case series adds to the evidence base that it may be possible to allow protected weight bearing during acute phase Charcot neuroarthropathy with adequate immobilization of the foot at all times.