1330_Landau.pdf

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1、Samantha Landau,DPM,MPH,FFPM RCPS(Glasg.)Department of Orthopedics&Pediatrics New York College of Podiatric MedicineNew York,NYPressure Mapping the Total Contact CastI,Samantha Landau,DPM have no relevant financial interests to disclose.Disclosure will be made when a product is discussed for an unap

2、proved use.DisclosureObjectives-Evaluate Total Contact Casting Technique&Goals-Evaluate data conducted on offloading technique-Discuss mechanics and pathomechanics related to application of TCC on the affected and contralateral-Discuss CAGA findings on affected and unaffected limbTotal Contact Casti

3、ng-What is it?A casting technique designed to offload a DFU(diabetic foot ulceration)in the weightbearing setting-can make from scratch or use pre-fabricated-Patients come in weekly for reapplication-Allows patients to work and attempt daily activities as normal as possible-Effective in reducing the

4、 plantar ulcerations-But dont forget the plantar ulceration was caused by something!Initial biomechanical examination is valuable for once ulcer heals*What is CAGA?The TCC seems to heal a higher proportion of woundsin a shorter amount of time than two other widely usedoff-loading modalities,the RCW

5、and the half-shoe.Successfully shows reduction in peak pressureBut what about the contralateral limb?What about CFOs?What happens after it heals?How toGoal:after well padded inner layers applied,fiberglass cast Tailor to desired ulcerationIf submet 2,make sure arch contact is full to offloadCan furt

6、her with felt paddingConsequences?-LLD,longer side is TCC side-Uneven weight,CAM boot is heavy-Unaffected limb effectively becomes shorter limb and lighter limb-CAM boot heights range from 1.44 inches to 1.75 inches-Has suprastructure implications,already present structural imperfections area additi