Larsen K, Holstein P
Prosthet Orthot Int. 1987 Apr;11(1):31-2. doi: 10.3109/03093648709079377.
Relief from external pressure and repetitive stress is a main concept in treating diabetic neuropathic ulcers. Ulcers on the tip of the big toe may be caused by abnormal extension of the big toe, which can be diagnosed only by observing the patient during barefoot walking. A flexor pad underneath the big toe eliminates the phenomenon, but in case of rigidity of the toe, extremely roomy toe boxes must be prescribed. Out of a series of 272 diabetic patients with skin lesions on the feet 18 suffered this phenomenon, in one case with bilateral ulcerations. Fifteen ulcers healed and below the knee amputation had to be carried out in 4 legs due to ischaemia.
减轻外部压力和重复性应力是治疗糖尿病神经性溃疡的一个主要理念。大脚趾尖的溃疡可能由大脚趾异常伸展引起，只有在观察患者赤脚行走时才能诊断出来。大脚趾下方的屈肌垫可消除这种现象，但如果脚趾僵硬，则必须开非常宽松的鞋头。在272例足部有皮肤病变的糖尿病患者中，18例出现了这种现象，其中1例为双侧溃疡。15个溃疡愈合，4条腿因缺血不得不进行膝下截肢。
