Reduction of digital plantar pressure by debridement and silicone orthosis

R. A. Slater, I. Hershkowitz, Y. Ramot, A. Buchs, M. J. Rapoport

Research output: Contribution to journalArticlepeer-review


The lesser digits are frequent sites of elevated plantar pressure and ulceration in the diabetic foot. We sought to determine whether debridement of callus and the wearing of a custom molded digital orthosis could significantly reduce digital plantar pressure. Fourteen patients with distal digital callus were studied. For each patient, the toe with the highest plantar pressure was selected. A computerized pressure mat was used to record the plantar pressure before and after debridement with and without a moldable silicone digital orthosis. Mean peak plantar digital pressures before treatment were 2.80 ± 0.7 kg/cm2 for the entire group. The digital orthosis alone reduced plantar pressure to a mean of 1.95 ± 0.65 kg/cm2 p < 0.05. Treatment by debridement similarly reduced pressure to 1.99 ± 0.76 kg/cm2 p < 0.05. The most effective reduction of pressure for all patients, as well as the most statistically significant, occurred when both treatments were given, with mean peak plantar pressure falling to 1.28 ± 0.61 kg/cm2 p < 0.01. Debridement and custom molded digital orthoses alleviate distal digital plantar pressure. Since elevated plantar pressure increases the risk of neuropathic ulceration, these treatments should be considered in the prophylactic care of appropriate patients.

Original languageEnglish
Pages (from-to)263-266
Number of pages4
JournalDiabetes Research and Clinical Practice
Issue number3
StatePublished - Dec 2006
Externally publishedYes


  • Debridement
  • Diabetic ulcer
  • Digital silicone orthosis
  • Neuropathy
  • Plantar pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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