Here is a piece featuring SALSA/CLEAR/UTHSCSA alums Ryan Crews, Adam Isaac, John Steinberg and us.
via Patient comfort vs diabetic wound healing: confronting nonadherence associated with removeable offloading devices | Lower Extremity Review Magazine
Thanks for post.
I have a similar diabetic patient and ulcer.
My greater concern is we have closed this patient ulcer several times to have him return with the same a few months later. We have tried numerous shoe and insert modifications.
I would like your point of view on keeping our patient closed… severe cavus foot as well.
I would want to rule out a cartilaginous or bony Os Interphalangeus which could be surgically removed and provide likely resolution for this continued breakdown.
Often seen with hallux limitus. Will keep coming back unless you surgically offload. I really like a destabilizing Keller. Removing the insertion of the brevis is key. Possible ATL also for difficult forefoot ulcers with equinus. Seeing the inside of the OR also psychologically let’s the pt know that this is no joke. Not just a little scrape. Blow this off for a few days and we are talking the “A” word.