Abstract
Background: Total contact casting (TCC) is effective in offloading the plantar aspect of the foot in patients with diabetes and neuropathic ulcers. These patients are considered at high risk for skin-related complications during TCC because of sensory neuropathy. The purpose of this prospective study was to determine the frequency of complications during treatment of neuropathic ulcers with TCC. Methods: Thirteen patients with 18 neuropathic ulcers were treated with TCC. The same orthopaedic surgeon applied a consecutive series of 82 total contact casts. The initial cast was changed in 3 to 4 days, while subsequent casts were changed weekly. Results: Fourteen complications occurred during the 82 castings (17%). None of the complications required alteration in the treatment protocol. Thirteen of the 14 complications involved skin irritation and the other complication was from a cast that became too tight. Fifteen of the 18 neuropathic ulcers healed with TCC. Conclusions: TCC can be used safely in high-risk patients with neuropathic problems, but minor complications should be anticipated. Major complications that interfere with the treatment of the plantar ulcer can be minimized with careful technique, close follow-up, and thorough patient education.
Original language | English (US) |
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Pages (from-to) | 556-560 |
Number of pages | 5 |
Journal | Foot and Ankle International |
Volume | 25 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2004 |
Keywords
- Complications
- Neuropathy
- Total Contact Casting
- Ulcer
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine