Abstract
We studied the effect of callus lesions on plantar pressures, and whether callus removal or wearing well-cushioned shoes reduced pressure at callus sites.
We measured plantar pressure in five patients with diabetic neuropathy and plantar callosities (six metatarsal heads and two great toes), using the foot-pressure distribution analyzing system, F-SCAN (Tek-Scan, Inc., USA). While subjects were standing barefoot, peak pressures (mean±SD) were significantly higher at eight callosity sites (2, 788±1, 772g/cm2) than at the same sites in twenty healthy subjects (451±247). Furthermore, peak pressures at these sites were significantly higher while walking barefoot than while standing still. With treatment, peak pressures were reduced in these areas by 53% from 2, 788±1, 772 to 1, 313±618g/cm2 (p<0.05). In addition, wearing well-cushioned Doctor shoes (Lowell Shoe, Inc., USA) reduced peak pressures by 67% before treatment of callosities and 79% after treatment.
These results suggest that a callus acts as a foreign body elevation plantar pressures, which can be reduced by callus removal and by wearing well-cushioned shoes, and thus, may prevent foot ulceration in diabetic patients with neuropathy.
