الفهرس 
Anatomy and Mechanics of the FootOnly 14 pages are availabe for public view
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Abstract
Peripheral neuropathy is a common complication of diabetes. Loss of protective pain sensation results in plantar diabetic foot pressure ulcers due to recurrent shear and tear forces. Offloading the pressure from the sole of the foot is crucial in the healing process of those ulcers.
In this study, we used offloading methods on50 patients
who had neuropathic plantar DFUs ( 25 surgical offloading and 25
mechanical offloading ) Patients were followed up for 6 months for time to healing and recurrence
In the surgical group 88% had a completely healed pressure ulcers while in the non-surgical patients 86,7% had a healed pressure ulcers at the end of follow up period (6 months).
Complications we faced during follow up period were infection, recurrence and non-healing.
Either surgical or non-surgical modalities could be used without significant difference between them in their outcome. We should tailor the most suitable method for every patient.
Conclusion
Offloading is a cornerstone in the management of plantar diabetic foot ulcers (DFUs).
Surgical offloading may accelerate the time to healing in comparison to non- surgical methods alone.
Non-surgical offloading is a feasible and effective method that requires a well- trained team to avoid the problems of ill-fitting footwear and to instruct the patient on how to use them on a daily basis.
Recurrence and non-healing were the drawbacks of both methods without significant difference between the two groups
Infection occurred only in the surgical group which was statistically significant Management of plantar DFUs should include multidisciplinary team work as:
• Diabetologist
• Podiatrist
• Radiologist
• Orthopaedic surgeon
• Physiotherapist
• Orthotist
• Well trained-nurse
We recommend conducting studies on a larger number of patients to reach better results.