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-
1.
Faglia E, Carvaggi C, Clerici G, et al: Effectiveness of removable walker cast versus nonremovable fiberglass off-bearing cast in the healing of diabetic plantar foot ulcer. Diabetes Care 33: 1419, 2010.
-
2.
Varma AK: Charcot neuroarthropathy of the foot and ankle: a review. J Foot Ankle Surg 52: 740, 2013.
-
3.
Morona JK, Buckley ES, Jones S, et al: Comparison of the clinical effectiveness of different off-loading devices for the treatment of neuropathic foot ulcers in patients with diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev 29: 183, 2012.
-
4.
Wu SC, Jensen JL, Weber AK, et al: Use of pressure offloading devices in diabetic foot ulcers. Diabetes Care 31: 2118, 2008.
-
5.
Guyton GP: An analysis of iatrogenic complications from the total contact cast. Foot Ankle Int 26: 903, 2005.
-
6.
Hartsell HD, Fellner C, Saltzman CL: Pneumatic bracing and total contact casting have equivocal effects on plantar pressure relief. Foot Ankle Int 22: 502, 2001.
-
7.
Shaw JE, His WL, Ulbrecht JS, et al: The mechanism of plantar unloading in total contact casts: implications for design and clinical use. Foot Ankle Int 18: 809, 1997.
-
8.
Myerson M, Papa J, Eaton K, et al: The total contact cast for management of neuropathic plantar ulcerations of the foot. J Bone Joint Surg Am 74: 261, 1992.
Evaluating Iatrogenic Complications of the Total-Contact Cast
An 8-Year Retrospective Review at Cleveland Clinic
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Background: Total-contact casting is an effective method to treat various pathologic abnormalities in patients with diabetic neuropathy, but its use is frequently associated with iatrogenic complications.
Methods: The largest retrospective review to date of iatrogenic complications of total-contact casts was conducted over an 8-year period at Cleveland Clinic.
Results: In the past 8 years, 23% of patients developed complications, and the most common complication was a new heel ulcer formation. Of these complications, 92.1% resolved, 6.4% were lost to follow-up, and 1.4% resulted in a partial foot amputation. Mean cast duration was 10.3 days for patients who developed a total-contact cast iatrogenic complication. The most common indication for the use of a total-contact cast was a neuropathic foot ulceration.
Conclusions: The results of this study support the use of total-contact casting in the insensate patient with diabetes. However, adequate staff training in total-contact cast application is recommended to reduce complications.
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