PMID: 16624218Apr 21, 2006Paper

Unloading mechanism in the total contact cast

Foot & Ankle International
Efraim D LeibnerBentley W Edmonds

Abstract

The effectiveness of total contact casts is postulated to be due to the reduction of plantar pressure. We investigated plantar loads to evaluate the mechanism by which total contact casts off-load the plantar surface of the foot to determine if it is the intimate molding of the weightbearing plantar surface or if a below-knee cast is necessary. Plantar pressures and forces in a total contact cast (TCC) were recorded in 12 healthy subjects, using the Pedar (Novel GmbH, Munich, Germany) pedobarographic system. The measurements were repeated after removal of the 'shank' portion of the cast (proximal to malleoli), leaving in effect, a well-molded shoe-cast (SC). Measurements included average force and peak pressure. All parameters were measured under two different loading conditions: single-leg standing balanced on the casted limb and over-ground walking. To assess the contribution of calf geometry, the 'calf ratio' was calculated by dividing the largest by the smallest circumferences of the calf. All parameters were compared between TCC and SC for each subject in each of the two conditions. Paired t-tests were used to evaluate significance, which was set at a level of p < 0.006 due to the Bonferroni Correction. Removal of the shan...Continue Reading

Citations

Jan 12, 2011·Diabetic Medicine : a Journal of the British Diabetic Association·J Burns, L Begg
Oct 9, 2018·Journal of Orthopaedic Surgery·Biswajit SahuBarsha Tudu
Jan 9, 2016·Journal of Foot and Ankle Research·Lindy BeggJoshua Burns
Aug 20, 2019·Foot & Ankle International·Nickolas NahmS Trent Guthrie

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