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.


Discussion in 'Diabetic Foot & Wound Management' started by jtm, Nov 22, 2011.

  1. jtm

    jtm Active Member

    Members do not see these Ads. Sign Up.
    How much is better the total contact casting than a walker cast? In Spain we have two main problems with the walker cast, it´s expensive (about 300 euros) and the low adhesion to the treatment. I think that tcc is a good option for neuropathic wounds, not only for the cost, it has good results (vascular surgeons have been using it for years with success, by the way those cast were made of plaster...).
  2. cperrin

    cperrin Active Member

    We use a scotchcast TCC to good effect and use them as our 'gold standard' treatment (although i hate that phrase) - however some patients just cant get on with them and obviously the contra-indications that go with them.

    We also use to the standard scotchcast boot but are now using the softcast slipper cast with some reasonable results at the moment. We also use aircasts and the machester heel cup for appropriate ulcerations.

    In an ideal world everyone would have a TCC but it all depends on the patient infront of you.
  3. Eviedence does not seem to show that, but the problem is walkers are not warn the same periodS as TCC -here - Effectiveness of Removable Walker Cast
    Versus Nonremovable Fiberglass
    Off-Bearing Cast in the Healing of Diabetic
    Plantar Foot Ulcer

    An Off-the-Shelf Instant Contact Casting
    Device for the Management of Diabetic
    Foot Ulcers

    But removable cast walkers work better when made irremovable - http://www.diabeticmctoday.com/HtmlPages/DMC0505/PDFs/DMC_Armstrong.pdffull text found below

    Diabetes: Options for Offloading

    maybe something here - http://www.oaac.ca/2009present/Neuropathic%20foot-%20Reilly.pdf

    But really I don´t deal with these patients - just waiting for some plastic to heat in the oven

    Hope it helps some
  4. cperrin

    cperrin Active Member


    The reason why these papers are around is because it isnt an ideal world!

    Some good references to the iTCC which does have very good use's and is definatley a help in areas - especially in places where not many people know how to TCC properly.

    I think the key thing in all those papers, is that they are trying to get other therapies to be as good as the TCC, and whilst many of them show to be as effective in areas, the vast majority of patients will still find a way to get the walker off - it just seems to be the nature of a lot of these type of clients. Hence why we are not in an ideal world.

    Thats why where possible i will TCC, but for people with a UoT score C/Ischamia, risk of rubs etc then walkers can work, as can slipper casts, scothcast boots...

    You do wonder at times if they know we are actually trying to help them :drinks

Share This Page