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Plantar pressures with total contact casting

J J Wertsch1, L W Frank, H Zhu

  • 1Clement J. Zablocki VA Medical Center, Milwaukee, WI 53295, USA.

Journal of Rehabilitation Research and Development
|October 1, 1995
PubMed
Summary
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Total contact casting significantly reduces plantar pressures, particularly in high-load areas like the metatarsal heads and heel. This study quantifies the pressure redistribution achieved by total contact casts (TCCs) for improved ulcer healing.

Area of Science:

  • Biomechanics
  • Podiatry
  • Orthopedics

Background:

  • Total contact casting (TCC) is a common treatment for plantar neurotrophic ulcerations.
  • Its effectiveness is attributed to reducing pressure over high-stress areas and redistributing load across the foot.
  • Quantifying this pressure reduction is crucial for understanding TCC efficacy.

Purpose of the Study:

  • To quantitatively assess the effectiveness of total contact casting in reducing plantar pressures.
  • To measure the degree of pressure redistribution provided by TCCs in key foot regions.

Main Methods:

  • Plantar pressures were measured using a portable microprocessor-based data-acquisition system.
  • Data were collected from six non-disabled individuals under two conditions: with and without TCC.

Related Experiment Videos

  • Pressure measurements were taken during cast-walking cadence.

    • Main Results:

    • Total contact casting led to significant reductions in plantar loading.
    • Decreases were observed under the first, fourth, and fifth metatarsal heads, the great toe, and the heel.
    • Specific average reductions included 69% (1st metatarsal), 63% (4th metatarsal), 32% (5th metatarsal), 65% (great toe), and 45% (heel).

    Conclusions:

    • Total contact casting effectively reduces vertical plantar pressures in critical high-load areas.
    • The study provides quantitative evidence supporting the mechanism by which TCCs promote healing of plantar neurotrophic ulcerations.