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Neuropathic foot ulceration treated by total contact casts
P W Laing1, D I Cogley, L Klenerman
1University Department of Orthopaedics, Royal Liverpool Hospital, England.
The Journal of Bone and Joint Surgery. British Volume
|January 1, 1992
Summary
Total contact casts effectively healed most neuropathic diabetic foot ulcers within six weeks. However, this treatment did not improve outcomes for ischemic ulcers, with one case requiring amputation.
Area of Science:
- Podiatry
- Diabetology
- Wound Healing
Background:
- Diabetic foot ulcers are a significant cause of morbidity.
- Insensitive feet in diabetic patients are prone to ulceration.
- Neuropathic ulcers are a common complication.
Purpose of the Study:
- To evaluate the efficacy of total contact casts in treating diabetic neuropathic foot ulcers.
- To assess healing rates and identify factors influencing treatment success.
Main Methods:
- A cohort of 46 patients with neuropathic foot ulcers was treated.
- Total contact casts were applied to the affected feet.
- Ulcer healing was monitored over a six-week period.
Main Results:
- The majority of neuropathic ulcers healed within six weeks.
- Ischemic ulcers showed no improvement with total contact casting.
- One patient with an ischemic ulcer developed gangrene and required partial foot amputation.
Conclusions:
- Total contact casting is an effective treatment for neuropathic diabetic foot ulcers.
- Ischemic diabetic foot ulcers may require different or adjunctive treatment strategies.
- Prompt intervention is crucial to prevent severe complications like gangrene.