Offloading only as a means of management of neuropathic ulcers: A Case series
Abstract
Neuropathic ulcers have been a cause of ongoing disability in vast majority of patients affected with conditions causing sensory impairment in the extremities, especially the lower extremities. Repeated weight bearing on the insensate and deformed part leads to skin breakdown, subsequent infection and chronic ulceration. Bony changes in the form of Charcot’s arthropathy are also evident in many cases. Sometimes such patients land into amputations as a consequence. Neuropathic ulcers can be due to various etiologies like diabetes, leprosy, spinal dysraphism or acquired spinal cord insults.
Various techniques of management of Neuropathic ulcers are described in literature ranging from debridement, Total contact casting, various dressing materials, antibiotics and orthotic modifications.
We describe a case series of 4 cases where thorough debridement and offloading only was used for management of these ulcers with excellent results.
Keywords: Neuropathic, Weight bearing, Charcot.