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A Guide To Offloading The Diabetic Foot

By Nick Martin, DPM, Tim Oldani, DPM, and Matthew J. Claxton, DPM | 40,684 reads | 0 comments | 09/03/2005

   Increased plantar foot pressure is a leading cause of ulceration in the diabetic population.1 Healing these ulcers requires adequate blood supply, control of infection, excellent wound care and offloading or pressure redistribution of the ulcerative area.2-16 Out of all these factors, offloading presents a particularly unique challenge in treating chronic wounds.

Offloading The Plantar Fascia: What You Should Know

By Douglas H. Richie, Jr., DPM | 46,381 reads | 0 comments | 11/03/2005

   Heel pain is the most common musculoskeletal complaint of patients presenting to the podiatric physician. While heel pain is estimated to comprise 10 percent of athletic injuries, the incidence of heel pain in the active and sedentary population appears to be significantly underreported in the medical literature. Most experienced practitioners report that heel pain complaints have risen to epidemic proportion over the past 20 years for reasons we still do not fully understand.    Certainly, changing demographics figures into the equation.

Inside Insights For Offloading Diabetic Neuropathic Ulcers

Clinical Editor: Lawrence Karlock, DPM | 12,300 reads | 0 comments | 07/03/2004

Offloading diabetic neuropathic ulcers comes with a unique set of treatment challenges. Some consider total contact casting the gold standard but whether it’s practical in a busy practice is highly debatable. Still, how can one arrive at a solution that will enhance patient compliance? With these issues in mind, our expert panelists share their thoughts and experiences with this topic. Q: How do you initially offload the plantar diabetic neuropathic ulcer? A: Lawrence G.

A Guide To Preventative Offloading Of Diabetic Foot Ulcers

Jason R. Hanft, DPM, Daniel T. Hall IV, DPM, and Ashish Kapila, DPM | 47,184 reads | 1 comments | 11/21/2011

Given the repetitive microtrauma experienced by patients with diabetic peripheral neuropathy, proper offloading is critical to the prevention of diabetic foot ulcers. Accordingly, these authors explore the potential of total contact casts, Charcot restraint orthotic walkers and other offloading devices, and discuss key factors that affect patient adherence.

Transitioning From Open Wound To Final Footwear: Offloading The Diabetic Foot

James McGuire, DPM, PT, CPed | 27,791 reads | 0 comments | 08/27/2012

Given the potential recurrence and complications with diabetic wounds, this author emphasizes the importance of adapting one’s offloading strategy as the wound progresses to healing. Accordingly, he discusses keys to assessing the biomechanical risks of patients with diabetic foot ulcers and offers insights from the literature on effective offloading modalities.

Why Are We Missing The Boat When Offloading Diabetic Foot Ulcers?

Doug Richie Jr. DPM FACFAS | 13,517 reads | 1 comments | 03/22/2012

I am presenting a lecture about offloading diabetic foot ulcerations at this year’s Midwest Podiatry Conference. In preparation, I reviewed a recent review paper by Peter Cavanagh, PhD, a respected authority on the subject of offloading the diabetic foot.1 He is also one of the pioneers of research in lower extremity biomechanics. Cavanagh’s findings are astounding.

Back To Basics: How To Ensure Effective Offloading With Total Contact Casting

Ryan H. Fitzgerald DPM | 11,909 reads | 0 comments | 11/21/2011

I recently had the opportunity to speak at a dinner meeting to a group of wound care clinicians. During a question and answer session, the topic of discussion drifted toward the use of total contact casting (TCC). I asked the meeting participants to indicate, with a show a hands, how many of them were using this modality regularly in their practice. I was shocked to see that the number was less than 10 percent.

Assessing The Use Of Ex-Fix For Offloading In Diabetic Limb Salvage

Dong Kim, DPM, Jeffrey McAlister, DPM, and Paul J. Kim, DPM | 10,638 reads | 0 comments | 01/30/2012

In lieu of the advancements in wound healing and innovations in surgical technique, limb salvage in the patient with diabetes remains a costly and complex endeavor.