PLANTAR PRESSURES WITH TOTAL CONTACT CASTING

Total contact casting has been used to aid in the healing of plantar n eurotrophic ulcerations. The efficacy of total contact casts in promot ing ulcer healing is presumably due to a reduction in the load over hi gh pressure areas with pressure redistribution over the entire surface of the foot. The purpose of this study was to quantify the effectiven ess of total contact casting in reducing plantar pressures. A portable microprocessor-based data-acquisition system was used for recording p lantar pressures. Plantar pressures were collected from six nondisable d individuals with and without total contact casting at cast-walking c adence. In our study, there was a decrease in plantar loading under th e metatarsal heads (first, fourth, fifth), the great toe, and the heel . The average decrease was 32% under the fifth metatarsal, 63% under t he fourth metatarsal, 69% under the first metatarsal, 65% under the gr eat toe, and 45% under the heel. Our study quantitatively showed that total contact casting does reduce vertical plantar pressures in high l oad areas.