5. Nonoperative Care and Footwear for the Diabetic Foot and Ankle Patient
Author: D.O. David E. Karges
Publisher: Springer International Publishing
Initial treatment of the diabetic foot is largely regarded to be nonoperative. The goal of nonoperative care is to maintain a stable, plantigrade foot, supported by a shoe or brace, which avoids excessive focal pressure phenomenon to the foot or ankle, resulting from repetitive loading. This includes sensory neuropathic soft tissue ulceration, fractures, dislocations, and chronic Charcot deformities affecting the ankle, hindfoot, midfoot, and forefoot. Whatever initial nonoperative treatment is selected, patient education, routine visual inspection of feet, appropriate pressure-dissipating accommodative orthotics, along with shoe and total contact boot wear are the keystones which help maintain a functional foot during gait and avoid complications.