Diabetes is renown as the primary disease that contributes to a loss of sensation in the feet. This loss of sensation is called diabetic peripheral neuropathy, abbreviated DPN. DPN is a symmetrical loss of sensation often described as a stocking/glove distribution, affected the feet and to a lesser degree, the hands. The loss of sensation that results from DPN is greater distal to proximal, meaning that the loss of sensation will typically be worse in the toes.

Carbon Graphite Spring Plates - treating diabetic ulcerations

Diabetes is renowned as the primary disease that contributes to a loss of sensation in the feet.  This loss of sensation is called diabetic peripheral neuropathy, abbreviated DPN.  DPN is a symmetrical loss of sensation often described as a stocking/glove distribution, affected the feet and to a lesser degree, the hands.  The loss of sensation that results from DPN is greater distal to proximal, meaning that the loss of sensation will typically be worse in the toes.

DPN is the single most important contributing factor to diabetic foot ulcers.  One of the most difficult diabetic ulcers to heal is the recurrent ulceration that forms beneath what's known as the interphalangeal joint (IP joint for short) of the great toe.  The IP joint is the joint between the two bones of the big toe.  The plantar aspect (bottom) of the great toe is a focal point of stress with each step.  During the toe-off phase of the gait cycle, the force to the plantar aspect of the IP joint is enormous.  In patients with diabetic peripheral neuropathy, this focus of force often results in a callus that progresses to an ulceration.  These ulcers as are particularly difficult to heal in that the patient simply can't feel the break down of the skin and formation of the ulcer.  And once healed, these sub IP ulcers often break down and recur.

One tool that I use to prevent recurrence of IP diabetic ulcers is a carbon graphite spring plate.  The spring plate has two attributes that decrease load to the IP ulceration.  First, the spring plate very rigid.  The rigidity of the spring plate decreases the range of motion at the great toe joint, thereby decreasing the load applied to the IP joint with each step.  The second attribute is the toe spring.  Toe spring is the rocker created by the spring plate.  When I speak of a forefoot rocker, think clog.  With a clog, you just roll off the forefoot.  And that's the same thing that happens with the rocker on a carbon graphite spring.

Diabetic ulceration beneath the IP joint of the great toe can be a serious wound, often leading to bone infection and digital amputation.  Use of a spring plate certainly can help to heal the initial ulcer and will help to decrease recurrence of the ulcer.

Jeff

Jeffrey A. Oster, DPM
Medical Advisor
Myfootshop.com

Updated 12/27/19