Safety of total contact casting in high-risk patients with neuropathic foot ulcers

Dane K. Wukich, John Motko

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


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 languageEnglish (US)
Pages (from-to)556-560
Number of pages5
JournalFoot and Ankle International
Issue number8
StatePublished - Aug 2004


  • Complications
  • Neuropathy
  • Total Contact Casting
  • Ulcer

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


Dive into the research topics of 'Safety of total contact casting in high-risk patients with neuropathic foot ulcers'. Together they form a unique fingerprint.

Cite this