title: Evaluating Iatrogenic Complications of the Total-Contact Cast: An 8-Year Retrospective Review at Cleveland Clinic.
abstract: BACKGROUND
  Total-contact casting is an effective method to treat various pathologic abnormalities in patients with diabetic neuropathy, but its use is frequently associated with iatrogenic complications.
  
  
  METHODS
  The largest retrospective review to date of iatrogenic complications of total-contact casts was conducted over an 8-year period at Cleveland Clinic.
  
  
  RESULTS
  In the past 8 years, 23% of patients developed complications, and the most common complication was a new heel ulcer formation. Of these complications, 92.1% resolved, 6.4% were lost to follow-up, and 1.4% resulted in a partial foot amputation. Mean cast duration was 10.3 days for patients who developed a total-contact cast iatrogenic complication. The most common indication for the use of a total-contact cast was a neuropathic foot ulceration.
  
  
  CONCLUSIONS
  The results of this study support the use of total-contact casting in the insensate patient with diabetes. However, adequate staff training in total-contact cast application is recommended to reduce complications.
authors.forename: Tammy M
authors.initials: TM
authors.lastname: Owings
authors.forename: Nicole
authors.initials: N
authors.lastname: Nicolosi
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Suba
authors.forename: Georgeanne
authors.initials: G
authors.lastname: Botek
mesh_terms: D002370:Casts, Surgical / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D014945:Wound Healing