Author(s): Striesow F
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Abstract BACKGROUND: Special bespoke footwear, according to F. I. Tovey, can prevent foot ulceration in patients with diabetic neuropathy. Its main features are: extra depth, shock-absorbing insole, and no toe-cap. Such medical footwear may also be produced industrially for feet without major deformities. However, its clinical efficacy needs to be demonstrated to get the approval by the European Community. PATIENTS AND METHODS: A follow-up study was set up in 57 diabetic patients with a history of neuropathic foot ulceration, to investigate the efficacy of the industrially produced special "Diabeticus" shoe (Thanner GmbH, Höchstädt/Germany). RESULTS: After a mean of 12 (SD 6) months, 26 ulcer relapses were noted. Of these, 8 occurred to 30 patients wearing the protective shoes > 8 hours/day, and 18 occurred to 27 patients wearing normal shoes > 8 hours/day (p < 0.02, Log rank). The relapse rate was unrelated to the appreciably high frequency of podiatry in both groups (median 36 vs 45 days; n.s.). CONCLUSION: The special shoes under study during a 12-month period proved to protect against neuropathic diabetic foot ulcer relapses, when worn more than 8 hours per day.
This article was published in Med Klin (Munich)
and referenced in Primary Healthcare: Open Access