Walker S C, Helm P A, Pullium G
Arch Phys Med Rehabil. 1987 Apr;68(4):217-21.
This study investigated healing rates of chronic diabetic neuropathic foot ulcerations located on the plantar surface of the forefoot (n = 30) versus those located on other parts of the foot (n = 25). Each type of ulceration was treated with total contact casting. Ulcerations in the first group were located on the metatarsal heads and toes, while ulcerations in the second group were located on the dorsum of the foot, heel, plantar arch, ankle, medial aspect of foot, and toe or transmetatarsal amputation sites. Successfully healed diabetic neuropathic foot ulcerations treated with total contact casting were rated according to patient age, ethnic origin, sex, patient weight, ulcer size, ulcer location, duration of ulcer prior to casting, and ulcer grade. Analysis of variance and posthoc analyses demonstrated that (1) total contact casting was a highly effective method of treatment regardless of ulcer location (forefoot ulcer healing time mean = 30.6 days; nonforefoot ulcer healing time mean = 42.1 days) and (2) forefoot ulcerations healed significantly faster than ulcerations located on other parts of the foot. Complex correlational relationships were explored in this study, and multiple regression equations were developed for each location grouping.
本研究调查了位于前足跖面的慢性糖尿病神经性足部溃疡（n = 30）与位于足部其他部位的溃疡（n = 25）的愈合率。每种类型的溃疡均采用全接触石膏治疗。第一组溃疡位于跖骨头和脚趾，而第二组溃疡位于足背、足跟、跖弓、脚踝、足内侧、脚趾或经跖骨截肢部位。对采用全接触石膏成功治愈的糖尿病神经性足部溃疡，根据患者年龄、种族、性别、患者体重、溃疡大小、溃疡位置、石膏固定前溃疡持续时间以及溃疡分级进行评定。方差分析和事后分析表明：（1）无论溃疡位置如何，全接触石膏都是一种非常有效的治疗方法（前足溃疡愈合时间平均为30.6天；非前足溃疡愈合时间平均为42.1天）；（2）前足溃疡的愈合速度明显快于足部其他部位的溃疡。本研究探讨了复杂的相关关系，并为每个位置分组建立了多元回归方程。
