Presentation:
-painless ulcer at plantar aspect of the foot

Examination:
-examination of ulcer
-site
-shape
-size
-depth
-clean (granulating) dirty ( pus/slough)
-associated lesions
-trophic changes
-callosities
-dry
-fissures
-predisposing factors
-numbness
-pulses- DP/PT
-deformity - prominent metatarsal bone

Common Qs:
1.Classification of DF.
-Wegener's

2.What is the pathophysiology of DF ulcer
-neuropathy -sensory (numbness), motor (small muscles imbalance- deformity) & autonomic
(dryness)
-angiopathy - small and medium size vessels(calcification,atherosclerosis)
-infection - polymicrobial
-trauma

3.How to assess foot circulation.
-ABSI
-Transcutaneous Oxymetry
-Angiography
-Doppler study
-Pulse oxymetry

4.How to manage DF ulcer
-dressing
-antibiotics
-debridement
-total contact cast
-rest/non wight bearing
-local amputation
-major amputation- BKA, AKA

5.Explain foot care in Diabetic pts.
a.proper foot wear:
-soft
-well covered
-wide toe box
-avoid high heel
b.regular foot inspection
c.correct nail cut
d.maintain moisture - cream
e.avoid wetness of webspaces
f.wear foot wear in house

Labels: Short cases in orthopaedics