Current Concepts In Total Contact Casting For DFUs

Eric Jaakola, DPM, and Anna Weber, DPM

1. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States. Centers for Disease Control and Prevention, Atlanta, 2005.
2. Boulton AJ, Vileikyte L, Rangnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005; 366(9498):1719-1724
3. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care. 1990;13(5):513-521
4. Armstrong DG, Wrobel J, Robbins JM. Guest Editorial: are diabetes related wounds and amputations worse than cancer? Int Wound J. 2007; 4(4):286-7.
5. NIH Cancer Fact Sheet. 2010, National Institute of Health. Available at .
6. Sheehan, P, Giurini, JM, Jones J, Aristidis, V, Caselli A. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial. Diabetes Care. 2003; 26(6):1879-82.
7. Snyder R, Cardinal M, Dauphinee D, et al. A post-hoc analysis of reduction in diabetic foot ulcer size at 4 weeks as a predictor of healing by 12 weeks. Ostomy Wound Manage. 2010; 56(3):44-50.
8. Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetess. Diabetes Care. 2006; 29(6):1288-93.
9. Margolis DJ, Kantor J, Berlin JA. Healing of diabetic neuropathic foot ulcers receiving standard treatment. Diabetes Care. 1999; 22(5):692-695.
10. Veves A, Falanga V, Armstrong DG, Sabolinski ML. Graftskin, a human skin equivalent, is effective in the management of noninfected neuropathic diabetic foot ulcers: a prospective randomized multicenter clinical trial. Diabetes Care. 2001; 24(2):290-5.
11. Armstrong DG, et al. Off-loading the diabetic foot wound. Diabetes Care. 2001; 24(6):1019-1022.
12. Helm PA, Walker SC, Pulliam G. Total contact casting in diabetic patients with neuropathic foot ulcerations. Arch Phys Med Rehabil. 1984; 65(11):691–693.
13. Sinacore DR, Mueller MJ, Diamond JE. Diabetic plantar ulcers treated by total contact casting. Phys Ther. 1987; 67(10):1543–1547.
14. Myerson M, Papa J, Eaton K, Wilson K. The total contact cast for management of neuropathic plantar ulceration of the foot. J Bone Joint Surg. 1992; 74(2):261–269.
15. Mueller MJ, Diamond JE, Sinacore DR, Delitto A, Blair VPD, Drury DA, Rose SJ. Total contact casting in treatment of diabetic plantar ulcers: controlled clinical trial. Diabetes Care. 1989; 12(6):384 –388.
16. Armstrong DG, Lavery LA, Bushman TR. Peak foot pressures influence the healing time of diabetic foot ulcers treated with total contact casts. J Rehabil Res Dev. 1998; 35(1):1–5.
17. Mueller NJ, Sinacore DR, Hastings MK, et al. Effect of Achilles tendon lengthening on neuropathic plantar ulcers. J Bone Joint Surg. 2003; 85-A(8):1436-1445.
18. Piaggesi A, Macchiarini S, Rizzo L, et al. An off-the-shelf instant contact casting device for the management of diabetic foot ulcers. Diabetes Care. 2007; 30(3):586-590.
19. Van De Weg FB, Van Der Windt DA, Vahl AC. Wound healing: Total contact cast vs. custom-made temporary footwear for patients with diabetic foot ulceration. Prosthet Orthot International. 2008; 32(1):3-11.
20. Mueller NJ, Diamond JE, Sinacore DR, et al. Total contact casting in treatment of diabetic plantar ulcers; Controlled clinical trial. Diabetes Care. 1989; 12(6):384-388.
21. Caravaggi C, Faglia E, De Giglio E, et al. Effectiveness and safety of a nonremovable fiberglass off-bearing cast versus a therapeutic shoe in the treatment of neuropathic foot ulcers. Diabetes Care. 2000; 23(12):1746-1751.
22. Birke JA, Sims DS, Buford WL. Walking casts: effect on plantar foot pressures. J Rehabil Res Dev. 1985; 22(3):18-22.
23. Hartsell HD, Fellner C, Frantz R, et al. The repeatability of total contact cast applications: implications for clinical trials. J Prosthetics Orthotics. 2001; 13(1):4-7.

Add new comment