2: Management options

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Foot deformities may result from chronic trauma to the foot. The most extreme example is repetitive trauma resulting in foot disfigurement - Charcot's arthropathy. The autonomic dysfunction results in auto-sympathectomy to the vascular supply. If there is absorption of bone, there may be subsequent micro-fractures and the smaller foot joints, particularly the metatarsal, metatarsal phalangeal and ankle joints, may collapse. Eventually, the arch of the foot will also weaken and collapse. This is often described as a `rockerbottom foot'. Charcot's arthropathy usually occurs 10-15 years after the onset of diabetes.11-14

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