No VTE was diagnosed during TCC treatment, whereas the risk of VTE during the entire CF treatment period was 0.96%, and hemodialysis was associated with a significantly increased VTE risk after CF diagnosis.
No venous thromboembolism events were diagnosed during total contact cast treatment in people with Charcot Foot.
Two individuals (0.96%) developed VTE after uncasting but before discharge from Charcot Foot treatment.
Eight additional individuals (3.8%) had VTE diagnosed after the end of Charcot Foot treatment and during follow-up.
Hemodialysis was associated with a significantly increased risk of VTE after Charcot Foot diagnosis.
The study population consisted of individuals with diabetes mellitus and active Charcot Foot treated with total contact cast at a Swedish university hospital.
This research suggests that people with Charcot Foot — a serious bone and joint condition caused by nerve damage, most commonly seen in people with diabetes — do not appear to face an elevated risk of blood clots (venous thromboembolism, or VTE) while wearing a total contact cast (TCC), even though they are largely immobilized during treatment. In a group of 209 patients followed for nearly 7 years on average, not a single blood clot was detected during the casting period itself. Two patients (about 1%) did develop blood clots after the cast was removed but before they were fully discharged from treatment, and eight more developed clots later during follow-up. The most notable risk factor identified was hemodialysis (kidney dialysis), which was associated with a 13-times higher risk of developing a blood clot after the Charcot Foot diagnosis. In fact, hemodialysis statistically accounted for all observed VTE events in the analysis. This suggests that kidney disease requiring dialysis, rather than the cast treatment itself, may be the primary driver of blood clot risk in this patient population. This research matters because clinicians treating Charcot Foot have sometimes been uncertain whether to prescribe blood thinners (anticoagulants) during the prolonged immobilization required by TCC treatment. These findings suggest that routine anticoagulation during TCC treatment may not be necessary for most patients, but that individuals on hemodialysis may warrant closer monitoring for blood clot risk throughout their Charcot Foot treatment course.
Schoug J, Katzman P, Uddman E, Löndahl M. (2026). Risk of Venous Thromboembolism in People Affected by Charcot Foot Treated With Total Contact Cast.. Journal of foot and ankle research. https://doi.org/10.1002/jfa2.70212