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Patients with isolated peripheral sensory neuropathy have a 1. 7-times increased hazard risk ratio of requiring an amputation. Those with neuropathy and a foot deformity (such as a hammertoe) have a 12-times increased hazard risk ratio, whereas patients with ulcerations have a 36-times increased hazard risk ratio of ultimately needing an amputation. 124. Figure 11-8 A: Charcot foot demonstrating erythema and swelling in an insensate patient with diabetic peripheral and autonomic neuropathy. B: Fractures in the foot and ankle in patients with Charcot arthropathy lead to mechanical instability and structural anomalies such as the rocker-bottom deformity seen in this patient. C: Patients with ulcerations and Charcot arthropathy have a 36-times higher likelihood of requiring a lower extremity amputation than a patient without peripheral sensory neuropathy.

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