Neuropathic plantar ulceration

Management of 111 trophic plantar ulcers existing in 100 patients of leprosy have been reviewed. Male preponderance with 4th and 5th decade of life predilection was observed. Most of the patients were of lepromatous type. Ulcers were grouped into superficial and deep. They were treated by various methods viz. plaster cast alone and in combination with curettage, posterior tibial neurovascular decompression and metatarsectomy. It was observed that ulcers heal faster if conservative plaster cast treatment is clubbed with surgical treatment of the ulcer. Indications of various surgical methods is defined. Role of proper footwear in the management of plantar ulcers has been emphasized.