Question

An 65-year-old obese male (BMI 33kg/m2) presents on an outpatient

clinic. During the systems examination, the physical therapist finds
an ulcer as shown in the picture below. The BEST long-term
management of this patient should include:
A. Foot intrinsic muscle training
B. Bi-phasic pulsed current
C. Total contact cast
D. Posterior leaf spring

Answer 1

The best long-term management option for a 65-year-old male with a foot ulcer is the utilization of a Total Contact Cast, as it aids in pressure off-loading and healing of diabetic foot ulcers.

Step-by-step explanation:

The best long-term management for an obese 65-year-old male with a BMI of 33kg/m2 and a foot ulcer should include a Total Contact Cast (TCC). The use of a TCC is essential for off-loading pressure from the foot, which is particularly crucial in patients with diabetic foot ulcers. Off-loading helps to promote healing, reduces the risk of infection, and prevents further tissue damage. Moreover, additional measures such as controlling blood sugar levels, maintaining good foot hygiene, and consistent monitoring to prevent complications like infections are also critical.

Foot intrinsic muscle training might be helpful in the overall management to increase foot strength and stability but would not be the primary long-term management strategy for the ulcer itself. Similarly, bi-phasic pulsed current can be used to facilitate healing, but it is not the standard care practice for long-term management. A posterior leaf spring might provide support to some patients but is not typically used for ulcer management. Therefore, the Total Contact Cast is the most recommended option for this patient's condition.