Diabetes affects nerves, as a result of which the feet becomes insensate and diabetics do not realize the amount of pressure that is exerted on a particular area, which leads to deformities, ulcers and callus formation.
Some common deformities are:
- Hammer toes
- Claw toes
- Mallet toes
All the above deformities result in making the feet more prone to ulcer, which then gets infected because of underlying high sugars.
These can be the presenting complaints
Pain (in many cases there may be no pain at all)
The goal should be prevention of an ulcer or a wound rather than treating the actual deformity.
Surgical correction of the deformity is advised only if the symptoms are unbearable, there is no other option or in rare cases, for cosmesis.
Preventing an ulcer over these deformities can be achieved with the help of silicon bands, silicon caps for hammer and claw toes. Severe cases will need footwear that help keeping the toes suspended to avoid pressure on those areas. Counseling and awareness is of paramount importance.
In case of bunion deformity, bunion splint can help preventing injury to that area.
In case of Charcot’s foot, total contact cast (plaster) or proper customized footwear, are the options available. Air cast shoes may also be used.