Total contact cast for management of neuropathic ulceration of the foot

Neuropathic foot ulcers are common in diabetic patients. One etiological factor is neural dysfunction. These ulcers are a major cause leading to limb loss and exist in 85% of diabetic patients undergoing amputations. A treatment modality of neuropathic ulcers is by weight-bearing relief of the affected area, which facilitates natural healing. The best way of providing such treatment is by the application of a total contact healing plaster cast which dissipates the pressure over the entire sole and shin. The method is successful in more than 70% of the cases. The major drawbacks of this process are the frequent need to change the plaster cast, which is extremely time consuming, and the need for a skilled artisan. This treatment protocol is dependent on the availability of conditions that will permit the artisan to create these total contact casts.