Total contact casts were better than removable cast walkers or half shoes for healing diabetic neuropathic foot ulcers
QUESTION: In patients with diabetes, what is the effectiveness of total contact casts (TCCs), removable cast walkers (RCWs), and half shoes for healing neuropathic foot ulcerations?
Design
Randomised {allocation concealed}*, unblinded, controlled trial with up to 12 weeks of follow up.
Setting
USA.
Patients
75 patients with diabetes who had clinically significant loss of protective sensation (>25 V) as measured with a biothesiometer, ≥1 palpable foot pulse or a transcutaneous oximetry measurement > 40 mm Hg at the dorsum of the fore foot, and a superficial neuropathic plantar diabetic foot ulcer corresponding to grade 1A (University of Texas Diabetic Wound Classification System). Exclusion criteria were active infection; wounds in locations on the heel, rear foot, or area other than the plantar aspect of the foot; severe peripheral vascular disease; or inability to walk without wheelchair assistance. 63 patients (83% men) completed follow up.
Intervention
25 patients were …
