Healing times of diabetic ulcers in the presence of fixed deformities of the foot using total contact casting.
In a diabetic foot, ulcers can lead directly to the loss of a limb, and they may be life threatening if the patient is not provided effective intervention directed at healing. This study reports on the healing times of diabetic neuropathic plantar ulcers in the presence of fixed deformities of the foot using the ambulatory method of total contact casting (TCC). In this study, 21 subjects with chronic diabetes mellitus, plantar ulcers, and fixed deformities of the foot were put in casts, and their progress was followed until the ulcers were completely healed. Results indicated that all of the ulcers healed. The average time to healing was 67 +/- 29 days. Ulcers located in the forefoot, midfoot, and rearfoot healed in an average of 35 +/- 12 days, 73 +/- 28 days, and 90 +/- 12 days, respectively. The location of the ulcer and the presence and location of a fixed deformity of the foot strongly correlated with and was predictive of healing time using TCC. The location of the ulcers and the location of the fixed deformities of the foot should always be considered by providers of rehabilitation who treat diabetic neuropathic foot ulcers using TCC.
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Program in Physical Therapy, Washington University School of Medicine, Diabetic Foot Center, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.
D000368:Aged; D002370:Casts, Surgical; D017719:Diabetic Foot / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005528:Foot / Q000503:physiopathology; D005530:Foot Deformities / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D013997:Time Factors; D016474:Weight-Bearing; D014945:Wound Healing