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The effect of diabetes on the lower extremity can be devastating. Surgical intervention on the diabetic foot must be carefully planned, and long-term results must be anticipated. The authors present a case history of a patient with multiple previous amputations of the forefoot, resulting in a severe deformity and a nonfunctional foot. Transmetatarsal amputation, if performed correctly, should provide a relatively functional extremity.
In this study, 16 subjects wore different types of immobilization devices while peak pressures on the plantar aspect of the foot were measured using the Electrodynogram (E.D.G.) system. Objective and subjective data were generated and analyzed. Peak pressures decreased on the plantar aspect of the foot as the form of immobilization progressed up the leg.
Mechanical Treatment of Plantar Fasciitis
A Prospective Study
A randomized, prospective study was conducted to compare the effectiveness of three individual mechanical modalities in the treatment of plantar fasciitis. Two hundred fifty-five subjects were randomly assigned to one of three treatment groups: custom-made orthoses, over-the-counter arch supports, or tension night splints. Subjects were treated for 3 months, with follow-up visits at 2, 6, and 12 weeks. No statistically significant difference was noted among treatment groups with respect to final outcomes based on first-step pain or pain felt during the day. However, there was a statistically significant difference among the three groups with respect to early patient withdrawal from the study due to continued severe pain, noncompliance, or inability to tolerate the device. Patient compliance was greatest with the use of custom-made orthoses. (J Am Podiatr Med Assoc 91(2): 55-62, 2001)
