Waaijman et al identified factors associated with a recurrent neuropathic plantar ulcer in a diabetic. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Amsterdam, Medisch Spectrum Twente and Maxima Medical Centre in The Netherlands.
Patient selection: diabetic with history of neuropathic plantar foot ulcer
Risk factors for recurrence:
(1) presence of a minor lesion (odds ratio 9.1)
(2) cumulative duration of past foot ulcers in months (odds ratio 1.03)
(3) barefoot peak plantar pressure
Factors associated with lower risk of recurrence:
(1) day-to-day variation in stride count (odds ratio 0.93)
(2) in-shoe peak pressure < 200 kPa with footwear adherence > 80% (odds ratio 0.43)
Unrecognized repetitive trauma is believed to be the underlying cause and offloading footwear can reduce the risk.
To read more or access our algorithms and calculators, please log in or register.
