Abstract
Objective The objective of this systematic review is to evaluate the clinical effectiveness of podiatric management in the treatment of the Charcot foot. Research questions How effective is podiatric management with: 1. reducing lesions, ulceration and surgical intervention 2. reducing hospital admission, and 3. improving the quality of life of subjects. Inclusion Criteria Participants Subjects with an active primary diagnosis of Charcot foot, and of neuropathic aetiology, irrespective of gender, race, age, or nationality. Excluded: Subjects with Charcot –Marie-Tooth disease. Interventions Immobilisation by using non weight bearing crutches or a total contact plaster cast, removable cast walkers, advise/dispense appropriate footwear, prescribing of orthotics, use of Bisphosphonates, removal of calluses, compared to placebo, no intervention, or compared with other standard treatment used for the treatment of Charcot foot. Outcomes 1. incidence of foot ulceration, infection, amputation 2. callus development; resolution of callus 3. number and duration of hospital admissions 4. acceptability of the treatment as measured by the number of people dropping out during the trial and post randomisation exclusions 5. Quality of life measures: average change on any scale at the end of treatment.
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