Sims et al modified the diabetic foot ulcer risk categories of Birke and Sims for evaluating a patient with diabetes. The authors are from Pennsylvania State University.
Patient selection: diabetic
Parameters:
(1) protective sensation intact
(2) high plantar pressure or deformity
(3) history of ulcer
(4) neuropathic fracture
Sensation Intact
Plantar Pressure or Deformity
History of Ulcer
Neuropathic Fracture
Risk Category
yes
no
no
no
0
no
no
no
no
1
no
yes
no
no
2
no
no
yes
no
3
no
yes
yes
no
4
NA
NA
NA
yes
5
where:
• The table assumes that none of the other risk factors can occur if protective sensation is intact.
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