防护鞋和鞋垫防治足底溃疡效果观察

THEEFFECT OF PROTECTIVE FOOTWEAR AND INSOLE ON PLANTAR ULCERS IN LEPROSY

麻木足及足底溃疡是麻风病严重残疾之一,其发生率高,危害性大,第一个溃疡往往是打开截肢大门的信号为了探索防护鞋和鞋垫在防治足底溃疡中的作用,我们从1990年12月至1992年12月在广东省东莞市潮州市、韶关市和清远市开展了防护鞋和鞋垫防治足底溃疡效果的观察。

The insensitive foot and plantar ulcer are serious disabilitis in leprosy,we observed effect of protective footwear and insole on plantar ulcers in Dongguan city,Shaoguang City,Chaozhou City,Qingyuan City,since 1990.Two hundred seventy-seven cases were studied,including 214' men and 63 wemen with age of 20 to 68 or average 47 years old.They heve over two pints without sensation among the 12 test points,including 8 on the front of foot and 4 on the hindfoot.The protective footwear and insole were provided for patients trained in self-care.After recording the conditions of insensitive feet and the nicer the shoe were given and following-up was done every six months.Robber-soled shoes were used as protectve footwear.The insole was made of rubber and the thickness was in 3-5 mm.with 15 shore-hardness.The inasole has a hole in sites of nlcers.Out of the 277 cases,4 cases were not willing to use the protective footwear,2 cases died.A total of 271 cases except above mentioned 6 cases have used the protectve footwear fourteen months on the average,showed in table 1.The changes of plantar ulcers before and after using the shoes and insole are showed in Tabel II.Out of the 271 cases,137 cases had plantar ulcers bef ore using the shoes,and the ulcers healed in 41 cades and 94 ulcers after using the footwear.Ulcers in front foot healed more than those in hindfoot,decreased by 52.6% and 13.2%respectively (P<0.01).Out of 271 leprosy cases with insensitive feet,137 cases have plantar ulcers.94 ulcers in 41 cases cured afterusing the footwear fourteen months.The result shows that the protective footwea useful for preventing and treatingplantar ulcers.The authors point out that the best way treat the ulcer is the operation combined with protective foootwear All the protective footwear can be shopped in manket and widely usued.But the protective footwear must have a soft insole and adequate size.The thickness of the insole has to be in 3-5mm.because a thick insole might make the room of the shoes lessened and give rise to new ulcers.The 15 of shore-hardness was proper for a soft insole.