Preventive and therapeutic strategies for diabetic foot ulcers

Chris C. Cychosz, Phinit Phisitkul, Daniel A. Belatti, Dane K. Wukich

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

A paucity of evidence exists to recommend the use of electrophysical therapy in the treatment of foot ulcers (Grade I). Achilles tendon lengthening has some of the most robust evidence among operative interventions for diabetic foot ulcers and appears to be effective for ulcers of the forefoot; however, caution must be taken to avoid complications due to overlengthening (Grade A). Gastrocnemius recession can be helpful in reducing forefoot pressure in patients suffering from mild to moderate equinus contracture (Grade B). Toe flexor tenotomy may be indicated with patients with toe ulceration resulting from dynamic forefoot deformities such as claw toe and hammer toe (Grade B). Selective plantar fascia release may offer benefit to patients with ulceration under the toe tip, interphalangeal joint, or metatarsophalangeal joint, according to one study. However, more evidence is needed before this technique is accepted into common practice (Grade I). A paucity of evidence exists to recommend the use of electrophyical therapy in the treatment of foot ulcers (Grade I). Achilles tendon lengthening has some of the most robust evidence among operative interventions for diabetic foot ulcers and appears to be effective for ulcers of the forefoot; however, caution must be taken to avoid complications due to overlengthening (Grade A). Gastrocnemius recession can be helpful in reducing forefoot pressure in patients suffering from mild to moderate equinus contracture (Grade B). Toe flexor tenotomy may be indicated with patients with toe ulceration resulting from dynamic forefoot deformities such as claw toe and hammer toe (Grade B). Selective plantar fascia release may offer benefit to patients with ulceration under the toe tip, interphalangeal joint, or metatarsophalangeal joint, according to one study. However, more evidence is needed before this technique is accepted into common practice (Grade I).

Original languageEnglish (US)
Pages (from-to)334-343
Number of pages10
JournalFoot and Ankle International
Volume37
Issue number3
DOIs
StatePublished - Mar 1 2016

Keywords

  • diabetes
  • forefoot disorders
  • tendon disorders

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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