Clinical evaluation and care of the insensitive foot.

Until fairly recently, foot deformity was accepted as part of the natural course of a disease with associated sensory loss such as Hansen's disease or diabetes. Now we recognize that most of this deformity is caused by physical forces and that, with proper care, deformity can be prevented. The therapist must perform accurate methods of assessment such as inspecting and palpating the skin, testing for sensory loss, recording footprints, and measuring foot volume and must provide knowledgeable treatment techniques. The patient must be taught how to care for his feet and how to prevent continued trauma with subsequent infection and bony absorption, which ultimately result in deformity that could have been prevented. These evaluation, treatment, and education techniques are discussed in detail.