Healing rates of diabetic foot ulcers associated with Midfoot fracture due to Charcot's arthropathy

L. A. Lavery, D. G. Armstrong, S. C. Walker

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

The aim of this study is to compare the effectiveness of total contact casts based on wound location in groups of patients with diabetes mellitus with neuropathic ulcerations under the forefoot and patients with midfoot ulcerations associated with acute Charcot's arthropathy. Twenty-Give consecutive diabetic patients with Meggitt-Wagner grade neuropathic foot ulceration (NU) and 22 consecutive diabetic patients with neuropathic ulceration and acute Charcot's arthropathy (CU) were selected for study. Larger wounds took longer to heal in both the CU (p < 0.0001) and NU groups (p < 0.0001). Duration of ulcer prior to treatment also was significantly associated with increased healing time in both groups (p = 0.008 NU, p = 0.03 CU). The CU group had larger wounds (10.3 ± 4.6 vs 7.7 ± 4.0 cm2, p= 0.04) but took significantly less time to heal (28.4 ± 13.0 vs 38.8 ± 21.3 days, p = 0.04) than did subjects with neuropathic ulcerations only. The NU group had their ulcers present for a significantly longer period of time prior to contact casting (88.5 ± 98.3 vs 17.7 ± 12.9 days, p = 0.001). In this study, subjects with ulcerations secondary to acute Charcot fractures healed more rapidly than in previous reports with healing times of forefoot neuropathic ulcers similar to previous studies. Every patient's ulcer healed. There were no cast-related ulcerations, infections, or hospitalizations. Concerns regarding the safety of total contact casts to treat well-vascularized superficial forefoot and midfoot plantar wounds appear to be unfounded.

Original languageEnglish (US)
Pages (from-to)46-49
Number of pages4
JournalDiabetic Medicine
Volume14
Issue number1
DOIs
StatePublished - Jan 18 1997

Keywords

  • Arthropathy
  • Contact casts
  • Neuropathy
  • Ulcer

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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