7. WHAT CAUSES HIGH
PLANTAR PRESSURE?
• DISPLACEMENT OF
METATARSAL CUSHION
DISTALLY
• NON ENZYMATIC
GLYCOLISATION
• LIMITATION OF MOVEMENT OF
1ST MTP JOINT
• REDUCED ELASTICITY
8. WHAT CAUSES HIGH
PLANTAR PRESSURE?
• DECREASED SUBTALAR JOINT
MOVEMENT
• EXCESSIVE PLANTAR
KERATOSIS
• THICKENING OF SESMOID
• ADHESIONS & SCAR TISSUE
9. HOW DOES FOOT INJURY
OCCUR?
• PEAK PLANTAR PRESSURE:1340kPa
• SYSTOLIC BP 120 mm OF H:15 kPa
• CAPILLARY PRESSURE :6 kPa
• DELAYED/ABSENT RECOVERY FROM
ISCHAEMIA
• DELAYED/ABSENT RECOVERY OF
NORMAL TISSUE OXYGEN CONC.
10. HOW DOES FOOT INJRY
OCCUR?
• REPATATIVE MODERATE FORCE
• INFLAMMATION
• ERYTHEMA AND WARMTH
• COLLECTION OF EXUDATE
• BLISTER FORMATION
• BREAKDOWN OF SKIN --- ULCER
11. NEED FOR PROMPT
TREATMENT OF FOOT ULCER
• 85% OF DIABETIC FOOT
AMPUTATIONS ARE DUE TO
INADEQUATELY TREATED FOOT
ULCER
• 30-50% AMPUTEES REQUIRE
CONTRALATERAL AMPUTATION
IN 3 YEARS
12. NEED FOR PROMPT
TREATMENT IF FOOT ULCER
• 10% MORTALITY IN THREE YEARS IN
AMPUTEES
• ECONOMIC LOSS TO FAMILY AND
SOCIETY
• 22% REQUIRE IPSILATERAL HIGHER
AMPUTATION
17. PRIMARY TREATMENT OF
DIABETIC FOOT ULCER
• PARENTERAL ANTIBIOTICS
• OFF LOADING OF AFFECTED
FOOT
• REVASCULARIZATION
• CORRECT FOOTWEAR
18. OBJECTIVES OF DIABETIC
FOOT WEAR
• REDUCTION OF EXCESSIVE
PLANTAR PRESSURE
• REDUCTION OF SHOCK
• REDUCTION OF SHEAR
• ACCOMODATION OF DEFORMITY
• STABALIZATION OF DEFORMITY
• LIMITATION OF JOINT MOVEMENT
19. OBJECTIVES OF DIABETIC
FOOTWEAR
• WIDE TOEBOX
• EXTRA DEPTH
• SOFT UPPERS
• MCR/PLASTAZOAT INSOLE
• INSOLE WING PAD
• ORTHOWDGE CORRECTION
• WELL FITTING SOCKS
21. PRPHYLACTIC SURGERY FOR
DIABETIC FOOT ULCER
• METATARSAL OSTEOTOMY
• METATARSAL HEAD RESECTION
• SESMOIDECTOMY
• DIGITAL ARTHROPLASTY
• BUNIONECTOMY
• LOCAL FLAPS