The effect of regular callus removal on foot pressures

Pitei, D.L.; Foster, Alethea Vm; Edmonds, M.

doi:10.1016/s1067-2516(99)80066-0

Cited by 83 publications

(55 citation statements)

References 10 publications

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“…The observation of increased plantar pressure in subjects with callus in this study was expected, thereby confirming previous reports (9,25). The reported relationship between callus and reduced tissue thickness is, however, a new observation, suggesting that callus builds up at sites with reduced cushioning in order to protect the skin from breaking down.…”

Section: Research Design Andsupporting

confidence: 92%

Plantar Tissue Thickness Is Related to Peak Plantar Pressure in the High-Risk Diabetic Foot

et al. 2001

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OBJECTIVE -To investigate the relationship among plantar foot pressure, plantar subcutaneous tissue thickness, severity of neuropathy (vibration perception threshold [VPT]), callus, and BMI in a large group of neuropathic diabetic patients at risk of foot ulceration. RESEARCH DESIGN AND METHODS-A total of 157 diabetic neuropathic patients (VPT Ͼ25 V) without either peripheral vascular or ulcer history were studied. Plantar foot pressure and plantar tissue thickness were measured at each metatarsal head (MTH) using an optical pedobarograph and an ultrasound scanning platform, respectively.RESULTS -A significant association was observed between peak plantar pressure and plantar tissue thickness at all MTHs (Ϫ0.26 Ͻ r Ͻ Ϫ0.61, P Ͻ 0.0001), with the least pronounced association at the first MTH. In addition, the pressure time integral was significantly associated with plantar tissue thickness (Ϫ0.24 Ͻ r Ͻ Ϫ0.57, P Ͻ 0.0001). BMI was significantly related to plantar tissue thickness (0.18 Ͻ r Ͻ 0.45, P Ͻ 0.05), but not to peak forefoot pressures. Subjects with callus had significantly reduced plantar tissue thickness at all MTHs except the first MTH and increased peak pressures at all MTHs (P Ͻ 0.001).CONCLUSIONS -This study confirms a strong inverse relationship between plantar tissue thickness and dynamic foot pressure measurements. Long-term follow-up of this patient population will confirm whether reduced plantar tissue thickness predicts the development of diabetic foot ulcers.

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Section: Research Design Andsupporting

confidence: 92%

Plantar Tissue Thickness Is Related to Peak Plantar Pressure in the High-Risk Diabetic Foot

et al. 2001

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“…Metatarsal head resections, however, may increase plantar pressure in other areas of the foot [106,107]. Furthermore, regular callus removal has been reported to have a beneficial effect on the reduction of plantar pressure [108,109].…”

Section: Surgical Offloadingmentioning

confidence: 99%

The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review

Bus

Valk

Deursen

et al. 2008

Diabetes Metab. Res. Rev.

223

182

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SummaryBackground Footwear and offloading techniques are commonly used in clinical practice for the prevention and treatment of foot ulcers in diabetes, but the evidence base to support this use is not well known. The goal of this review was to systematically assess the literature and to determine the available evidence on the use of footwear and offloading interventions for ulcer prevention, ulcer treatment, and plantar pressure reduction in the diabetic foot.

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“…Both excessive callus formation and limited joint mobility have been reported to increase the risk for foot ulceration [13][14][15]. Furthermore, the removal of excessive plantar callus in diabetic patients can reduce peak pressures underneath the foot with 25-32% [16,17]. Limited mobility at the ankle and first metatarsalphalangeal joints affects the normal roll-over process of the foot during stance and increases the plantar pressures in the forefoot and toes [18,19].…”

Section: Foot Pressure Increase and Ulcer Riskmentioning

confidence: 99%

Foot structure and footwear prescription in diabetes mellitus

Bus

2008

Diabetes Metab. Res. Rev.

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Foot structure abnormalities such as foot deformity and limited joint mobility are common and well established components of the diabetic foot which are associated with increased levels of mechanical stress on the foot and the development of ulcers. Our understanding of foot structure abnormality in diabetes has improved recently, mainly through the findings from in vivo imaging studies. Several examples will be discussed in this review. A limited understanding, however, still exists about several aspects related to the assessment, etiology, and consequences of change in foot structure in diabetes. Knowledge on these matters is needed if we are to better deal with the implications of foot structure change in diabetes. Diabetic patients with neuropathy and foot deformity are commonly prescribed with custom footwear, in particular after ulcer healing. The goal of this footwear is to redistribute and reduce plantar foot pressures, and to prevent ulcer recurrence. However, the available evidence for the effectiveness of custom footwear in secondary ulcer prevention is not yet strong. This may be associated with several factors, including a lack of standardized or systematic approach (a set of guidelines) in footwear prescription and evaluation or with the significant variability that exists across patients in the offloading effect of different footwear interventions, which increases the difficulty of predicting what works for a given patient. Objective evaluation tools such as in-shoe plantar pressure analysis can be helpful in this regard in order to ensure efficacy of an intervention. This provides a more optimal footwear solution that may lower the risk for ulceration.

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The effect of regular callus removal on foot pressures

Cited by 83 publications

References 10 publications

Plantar Tissue Thickness Is Related to Peak Plantar Pressure in the High-Risk Diabetic Foot

Plantar Tissue Thickness Is Related to Peak Plantar Pressure in the High-Risk Diabetic Foot

The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review

Foot structure and footwear prescription in diabetes mellitus

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