Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Off loading for Acute Charcot + Falls Risk

Discussion in 'Diabetic Foot & Wound Management' started by kimmyed, Nov 1, 2012.

  1. kimmyed

    kimmyed Welcome New Poster


    Members do not see these Ads. Sign Up.
    Hi All,
    If anyone can offer some advice in relation to offloading alternatives for a patient with diabetes, p.neuropathy, heart failure, adequate peripheral vascular status, previous amputation of right hallux to mid shaft of 1st met and 2nd toe (2011). He has very poor balance and OA of left knee, uses walking stick for ambulation and has had 2 falls in past 12mths. He is on warfarin. Diabetes is reasonably well controlled on insulin (most recent HbA1c 7%), recent BSLs stable, no fevers/ chills, seems systemically well. Apparently, inflammatory markers (ESR/CRP) were elevated last week (not sure what the values are - i dont have access to blood work).
    He has a current chronic ulceration plantar 4th MTP, present since June. Today, there is probe to bone, wound diameter 6mm, clear serous exudate, no malodour. Patient reports it has not worsened recently, and volume of exudate is stable.
    He has an acute charcot with dislocation 3/4 MTPs - 5degree temp difference, erythema and oedema to mid-calf.
    I have ordered plain X-rays, with view to MRI.
    Just wondering if you have any suggestions for pressure deflection in this type of patient who is falls risk. He reports in the past he has tried a CAM walker and was too unstable to feel safe ambulating in it.
    Your assistance with this case would be much appreciated.
     
  2. Tuckersm

    Tuckersm Well-Known Member

    A wheel chair
     
  3. WApod

    WApod Member

    Hi,
    If he really can't manage with a device that allows ambulation then a TCC / aircast + wheelchair really is the best way to go.
    If he is more unsteady with the height difference rather than dangerous for falls because of the rocker / restricted movement then an evenup on the other foot may help a bit, especially if it's along with a 4 wheeled walker or Zimmer for added stability.
     
Loading...

Share This Page